Registered Nurse (RN)
Medical Surgical Nursing & Pathophysiology
Stroke & Traumatic Brain Injury
Right Hemisphere Stroke Assessment

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Right Hemisphere Stroke Assessment

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Right Hemisphere Stroke Assessment

Right Brain Stroke-crew Assess-man
The location of the brain affected by stroke determines the severity of impaired functioning. A stroke affecting the right hemisphere causes left side hemiplegia. The patient may experience poor proprioception and disorientation to person, place, and time. The patient may not recognize familiar faces. Right sided stroke may cause impulsive behavior, poor judgment, personality changes, and tonal hearing loss.
Opposite Side Weakness (Hemiplegia)
Opposite Side Weak and drooping

Since the pyramidal pathway crosses the medulla, one side of the brain affects the motor function on the opposite side of the body. Right hemisphere stroke causes left side paralysis and possibly left-sided neglect. Assess the patient's response to stimuli on the left-handed side. Use visual and tactile stimuli to increase reintegration of the affected side.

Poor Proprioception
Broken Propeller-scepter

Right hemisphere stroke affects spatial-perceptual orientation. Damage to the parietal lobe may cause the patient to deny their disabilities or their own body parts. The patient may neglect all sensory inputs on the left side of the body. Additional deficits include the inability to judge distances, to recognize an object, and to move in a learned sequence. Poor proprioception may increase the patient's risk of accident and injury. Assess the patient for altered proprioception, since the patient may be unaware of their deficits.

Disoriented to Person, Place, Time
Disoriented-map with Person, Place, and Time

Damage to the right hemisphere impairs the patient's concept of time. The patient may be disoriented to person, place, and time. Frequently re-orientating the patient may help improve their concept of time.

Can't Recognize Faces (Prosopagnosia)
Unrecognizable Faces

Prosopagnosia refers to the patient's inability to recognize faces. Encourage the patient's loved ones to continue communication efforts to maintain relationships.

Loss of Judgement and Awareness
Judge and Witnesses Leaving

Right hemisphere stroke may result in decreased awareness and poor judgment. The patient may benefit from rearranging the environment to compensate for visual deficits and decrease the risk of injury.

Impulsive M-pushing

Right hemisphere stroke tends to cause rushed movements and impulsive behavior. Create a safe environment and monitor the patient's activity to prevent injury.

Personality Changes

Damage to the right hemisphere may cause changes in personality. The patient may experience emotional lability and present with constant smiling, euphoria, confabulation, or crying. Inform the patient's loved ones that not all personality changes are permanent.

Tonal Hearing Loss
Can't Hear Tuning-fork

After experiencing a right hemisphere stroke, the patient may have tonal hearing loss. Right brain damage may affect the patient's ability to distinguish tonal variations. Maintain a normal volume and tone while speaking with the patient.


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