Care compassion and communication.
An ischemic stroke happens when there is an obstruction inside that restricts supply blood to the brain (TIA) (Stroke Association, 2014). A stroke is a severe therapeutic condition that occurs when the blood supply to the other parts of the body is cut off (National Health Services, 2013).There are two main types of strokes: Ischaemic stroke which is caused by blood blockage in the vessels, and haemorrhagic stroke which occurs when a blood vessel bursts making the blood to seep into the brain.
The daily living activities of communication, eating and swallowing are central to her care plan for patients with stroke as they are the major aspects representing the effects of the stroke. Some patients are left with slurred speech. Patients with stroke are referred to speech and language specialist for assessment. After the assessment some patients found with dysphagia. According to Stroke Association (2014) Stroke is the cause of dysphagia and it is happens when a stroke causes weakness of the muscles you use to speak. This may affect the muscles you use to move your tongue, lips or mouth, control your breathing when you speak or produce your voice (Stroke Association, 2012).Thus targeted therapy help with swallowing problems and suggest ways to other ways of communicating better using talking , reading and writing. Frontal lobe this may involve gestures, communication charts or possibly an electronic aid.
Swallowing problems occur after stroke when the parts of your brain that control swallowing are affected (Stroke Association, 2012) The medical term used to describe any difficulties or pain in eating, chewing, drinking or swallowing is dysphagia (Stroke Association, 2012. A team of different healthcare professionals, including a doctor, speech and language therapist, dietician and nutrition nurse, worked closely to manage stroke patients.

The presentation of a patient’s food may need changing to ensure they can swallow it safely. This may involve altering the temperature, texture, taste and thickness (Stroke Association, 2012).
Patients who fail to eat normal diet and did not to like the puree diet; this placed them at a risk of malnutrition. Therefore it is imperative that an assessment of a patient’s nutritional need is carried out on admission. Nurses must use the assessment tool which British Association for Parental and Enteral nutrition (BAPEN, 2007) recommends the use of Malnutrition universal screening tool (MUST). This uses 5 simple steps to identify those at risk of malnutrition. Mary had a body mass index (BMI) of 31.1 but scored two due to acute disease effects (ADE), (BAPEN 2007).
The Nice (2013) guidelines recommends swallowing therapy at least 3 times a week to people with dysphagia after stroke who are able to participate, for as long as they continue to make functional gains.
A referral to the dietician must be done so as