Altered Nutrition Case Study
An older client is discharged from the hospital to rehab after suffering a cerebral vascular accident (CVA)
often referred to as a stroke. The client lives with her spouse who is in good health. The rehab nurse
enters the room to assess the client.
Nursing Process
The nurse’s assessment findings include right-sided weakness, slurred speech, and dysphagia. The nurse
identifies that the client is at high risk for several problems.
1. Of the client problems addressed on the nursing plan of care, which is the highest priority
problem?
a. Aspiration
b. Skin Breakdown
c. Altered Nutrition
d. Self-Care Deficit
2. After establishing priorities, the nurse should take which action next in developing the client’s
plan of care?
a. Analyze Data
b. Establish Outcomes
c. Complete an assessment
d. Implement Interventions
The nurse visits with the client’s spouse and then observes as the unlicensed assistive personnel (UAP)
assists the client with her meal. The UAP gives her a glass of iced tea to drink and the client begins to
cough. The nurse recognizes that the client’s dysphagia may impact her fluid and nutritional status.
1. The nurse plans interventions related to the client’s dysphagia. To which member of the
interprofessional team should the nurse obtain a referral order?
a. Case Manager
b. Speech Therapist
c. Registered Dietician
d. Geriatric Nurse Practitioner
The Nurse recognizes that the client’s right-sided weakness is also a factor contributing to her risk for
altered nutrition.
2. With which member of the interprofessional team should the nurse consult regarding this
problem?
a. Clinical nutritionist
b. Occupational therapist
c. Rehabilitation counselor
d. Physical therapist
