Question

NU UI DIUl Function Mrs. Joy reports, "My husband was okay until about 4 months ago in Arizona when he began having trouble driving. He also could not recall where he put things and soon after that couldn' remember our friends' names. He got more withdrawn and not very talkative. I am afraid he might have had a stroke, or worse, he may have Alzheimer's disease. What do you think?"| 1. What additional information may be helpful for the health care provider to determine the diagnosis? 2. What are some typical manifestations associated with a stroke? Mrs. Joy says, “I know there are two kinds of strokes, so if he had one, I sure hope it was the good kind." 3. What information will provide a basis for the response? 4. What are some typical manifestations associated with Alzheimer's disease? 5. Based on Mr. Joy's presenting symptoms, what does the nurse suspect, and how could this confirmed? Mr. Joy was diagnosed with Alzheimer's disease, and he was referred to a neurologist and the couple to a support group.

Answer 1

1Additional information required to determine the diagnosis:

Besides the information provided above following information will be required by the health care provider to reach at some diagnosis

.Medical history

. family history

.laboratory and imaging test

.physical and neurological examination

2.Typical manifestations of stroke:

stroke is caused by interruption of blood supply to part of brain.it has following manifestations

.slurring of speech and drooping of face on one side on smiling.

.para lysis or numbness of face ,arm or leg.

.headache

.trouble in walking and balancing

3Information for the basis of response:

As given in above passage ,the patient is not able to recall his family members ,.having trouble doing routine tasks lijr driving,and he forgets the things kept my him.it clearly indicates that he might b suffering from Alzheimer's disease which can be confirmed by further tests

4Manifestations of Alzheimer's disease:

preclinical stage:no symptoms but toxic changes are taking place in brain.

clinical signs:may very from person to person

early stage:

memory loss

poor judgement

taking longer time to complete daily task

repeating questions

wandering and getting lost

short attention span

inability to recognize family members

late stage:

Mood and personality changes

Increased anxiety and aggression

weight loss

difficulty in swallowing

increased sleep

loss of bowel and bladder control

5confirmation of diagnosis:

Based on the findings most probable diagnosis is Alzheimer's disease which can be confirmed by following tests

evaluation by neurologist or geriatrician:

He will evaluate :

.impairment of cognitive skills

.changes in personality

.degree of memory loss

interview with friends and family to get more thorough information

Blood test:

to rule out thyroid disorders and deficiencies

Diagnostic imaging tests:like MRI,CT scan,PET scan to rule out

tumors

stroke

head injury

identify degenerative pattern

areas of decreased metabolism in brain