Mr. J is a 62 year-old patient who has a history of GERD, Rheumatic Heart Disease, hyperlipidemia and hernia repair. His wife brought him to the Emergency Department for suspected stroke at 6:30pm this evening. Mrs. J states that her husband began complaining of a headache shortly before dinner. Additionally, during their meal, Mr. J was unable to pick up his fork and was having difficulty speaking. Initial VS are as follows: HR 112 a-fib, RR 28, SAT 92% on room air, BP 175/100, Temp 97.4 orally. A head CT was done, showing no evidence of a hemorrhagic stroke. Further evaluation utilizing the NIH Stoke Scale confirmed the likelihood of Mr. J having an ischemic stroke: positive drift to the right arm and right arm ataxia with moderate aphasia and dysarthria.
The neurologist places an order for a tPA gtt with q 15 min neuro checks and VS monitoring. Mr. J is subsequently admitted to the ICU for close monitoring.
1. What does the acronym F.A.S.T. stand for? What criteria did Mr. J meet with this stroke assessment?
2. What may have been attributing factors to Mr. J having a stroke? (explain)
3. What area(s) of the brain is likely being effecting by the stroke? (be descriptive)
4. Explain the purpose of tPA for this patient. What side effects must the nurse monitor for?
1.F.A.S.T is an assessment tool for stroke.It stands for
Face:The patient shows a typical symptoms of facial drooping on one side.This is usually identifiable by smile ,where asymmetry is noted
Arms:Here the patient has weakness,numbness or paralysis of the limb.It is exhibited on the opposite side of the affected part of the brain
Speech:The patient will definitely have difficulty in conversing or speaking
Time:If any of these symptoms are exhibited by a patient ,its time to shift a patient to medical help to prevent any further damage.
The criteria which Mr.J meets are
2.The attributing factors which caused Mr.J to have a stroke is hyperlipdemia. This can lead to deposition of fats in the lining of arteries and resulting in narrowing of the blood vessels and leading to decreased or absence of blood supply. This is also termed to be atherosclerosis. causing a clot and resulting in blocking the blood supply to brain blood vessels and causing ischemic stroke.
3.The brain has three parts namely cerebrum,cerebellum and the spinal cord.
The cerebrum has two hemispheres (right and left) .It's main functions are sensory (vision,hearing,touch ,smell),thinking,interpreting, reasoning, speech,fine motor movements.In ischemic stroke the cerebrum is affected.If it is on the left side then patient symptoms are seen on the right side of the body.
4.tAP (Tissue plasminogen assay) is a protein responsible for breaking a clot formation. The main purpose for administration of this is for breaking the clot and enhancing blood flow to the affect brain parts.
The following side effect had to be monitored by a nurse
Mr. J is a 62 year-old patient who has a history of GERD, Rheumatic Heart Disease,...
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