Question

c u y y paper to suPPORT YOU WIR Nursing care management for a stroke patient Presentation: You inherit a new patient F. L. who has a history of "recent stroke." He was recently (approximately 3 months ago) hospitalized, but you don't have his records at the moment. The patient's wife wanted him "checked out," and states that his "cat scan" showed a stroke. She claims, "They did a bunch of other tests but didn't find anything." She does not think he has hypertension but adds, "He does not like to go to doctors. The past medical history is unknown. He does report taking aspirin 81mg daily and does not have any ent F. L. smoked one pack a day but quit five years ago, however he does drink socially. As for his family history, his mother died at the age of 79 from a stroke and his father died at the age of 64 from a myocardial infarction, he is the only child. He is 57 years old, married to his wife for 29 vears and has three children He works Monday through Friday as an accountant. Medications: Aspirin 81mg daily Review of systems: Subtle left hemiparesis; increased tone and hyperactive reflexes, very mild neglect of his left side Physical exam: Vitals, height = 72", weight = 225, body mass index = 30.5, blood pressure - 15099 mm Hg: heart rate93 beats per minute at rest. 1) Describe the pathophysiology of a stroke 2) What would your nursing assessment consist of? What should you be cognitive of with stroke patients? 3) What are three short-term goals for this patient? 4) What are three nursing interventions for this patient? 3) What are three things you would discuss with the patient and his family during your discharge teaching? 6) What are two medications (other than aspirin) that could be provided for this patient and why? a. What is the mechanism of action of each? b. What are some of the possible side effects associated with these medications? c. How would the patient benefit from taking these medications? 7) What are three recommendations for follow-up care? Page 1 of 1 Words 447

Answer 1

1)pathopysiology

ischemic-in hypertension,DM etc causes ischaemia

Haemorrhagic-thrombotic-atherosclerosis in cerebral arteries causes less blood supply and once this thrombus enlarge -lumen blocked.

-embolic-atrial fibrillation, infectious endocarditis

(2)whole cns examination is done of both sides-higher mental functions, cranial nerves, somatic and motor system, cerebellar system etc.

1. Do Not Let that person go to sleep or talk. Stroke survivors often complain of suddenly feeling very sleepy when a stroke first happens.
2. Do Not Give them medication, food, or drinks.

3)goals-

• Maximize each person's functional abilities and level of independence.
• Provide extensive training and education for the person and their family.
• Rebuild the person's quality of life.

4)aspirin,thrombolysis(if ischemic stroke), statins(if Haemorrhagic stroke), anti hypertensives.

5)during discharge, advise

• Lower blood pressurea
• Lose weight
• Exercise more
• If you drink — do it in moderation.
• Treat diabetes by medication
• Quit smoking

6)thrombolysis and statins

Reduce thrombus or emoboli, improve blood flow, maintain cerebral circulation.