Question

Patient is a 63 year old Senior Partner in a Law Firm. While eating breakfast Michael experienced sudden onset slurring of speech, had facial droop on his left hand side with weakness in left side upper and lower limbs. Michael's wife Mary spotted these sudden onset of symptoms and immediately called for an ambulance, which arrived within 15 mins.

Past Medical History

Asthma - Dx Aged 8

Hypertension Grade 1 - Dx 5 years ago

Prediabetes - Dx 3 years ago

Atrial Fibrillation- Dx 2 years ago

Hyperlipidemia - Dx 2 years ago

Medication History

Breo MDI

Ventolin (As Required - Not Required for over 1 Year)

Thiazide

Social History

63 Year Old Senior Partner at a Law Firm, recently reduced working hours 20 - 30 hours per week, previously worked 50 - 60 Hours. Plans on retiring within 2 years. He lives with his wife, Rachel. He has 2 adult children, both married with their own children.

Lifestyle Changes implemented over past 2 - 3 Years following diagnosis of prediabetes.

Outside work he enjoys golf, usually playing at least 2-3 per week. Also enjoys playing bridge with Friends.

Took up walking 3 Years ago following Dx Prediabetes. Walks 5 - 6 days per week for between 30 - 45 mins

Ex-Smoker - Hx Smoking 30 Years x 10 - 15/day - Quit 3 Years ago following Dx Prediabetes

Social Beer Drinker 10 - 15 Standard Drinks per week with 3 - 4 per session, although sometimes after Golf may be more.

                

Acute Hospital Assessment

Vitals:

BP 145/90 mmHg

Pulse 82

Physical Exam:

Confusion

Left Facial Droop

Slurred Speech

Left Motor Weakness Upper Limb 0/5, Lower Limb 2/5

Decreased Tone

Altered Sensation

Mild Left Sided Neglect      

Please list this patient's risk factors of CVA (, also known as stroke or brain attack).

Complete a list of medications this patient should be taking for his stroke risk factors .

Please use Nursing review peers and nursing research, reference and citations required

Answer 1

Stroke occurs when there is ischaemia to a part of the brain or haemorrhage into the brain that results in death of brain cells.Risk factors can be divided into modifiable and nonmodifiable .Modifiable risk factors include hypertension ,heart disease,smoking,excessive alcohol consumption,obesity ,sleep apnea,metabolic syndrome,lack of physical excercise,poor diet and drug abuse.Non modifiable risk factors include age,gender,race and family history/heredity.

Drug therapy

• Pharmacology therapy for primary prevention of stroke in Diabetic patient is Aspirin,75-162mg/day.
• In Afib ,Warfarin and Aspirin.
• Blood pressure control -ACEI.
• Cholesterol reduction-Statins