Questions on Cognitive and Neurological Function: Case Study of Mr. J

1. Which one of Mr. J symptoms supports a diagnosis of stroke?

Mr. J. has slurred speech, takes aspirin for stroke conditions, gets severe headaches, and is numb in one side of the body (Mayo Clinic, 2015).

• What are the risk factors Mr. J presents for the development of stroke?

Mr. J is a high-risk candidate for stroke because he is over 55 years old, an African-American, has irregular breathing and heartbeats, high blood pressure, and overuse of drugs for various conditions (Davis, 2015).

• Indicate the type of stroke Mr. J most likely had, and support your answer.

Of three types of stroke, ischemic or blocked brain arteries, hemorrhagic or ruptured blood vessels blocking blood flow, and transient ischemic attack (TIA) or minor stroke lasting a few minutes (Mayo Clinic, 2015), Mr. J is likely to be having hemorrhagic stroke. He has a high BP and acute headaches.

• What evidence is presented to support that Mr. J had experienced previous TIAs?

Mr. J has a history of hypertension and diabetes mellitus-type 2. He has previously lost motor control on his right side because of poor blood circulation. He has previously had memory loss when he forgot to take his medicine and spent money on horse races (Mayo Clinic, 2015).

• Why is atrial fibrillation a risk factor for embolic stroke?

Atrial fibrillation is a heart condition, while embolic stroke is a blood clot near the heart, therefore a weak heart condition, for example is older persons, can lead to embolic stroke. High blood pressure caused by binging and rapid heartbeats, can lead to artery busting. Sleep apnea or irregular breathing, affects heart rhythm raises the risk of pushing a clot to the brain. Obesity creates a fat layer around the heart leading to embolic stroke (Mayo Clinic, 2015).

• Explain the rationale for each of the interventions conducted for Mr. J.

Vital tests were conducted for BP which was high, heart rate which was fast, temperature which was slightly high, right hemiplegia and hemiparesis which turned positive, and for slurred speech. Oxygen was administered through nasal cannula at 2ltr/minute to regulate breathing and heartbeat. Intravenous infusion of normal saline at 80ml/hr was administered to control fluid loss and shock that occurred during TIA. ECG was done to monitor his heart’s electro-pulses and determine his risk level for stroke. A cranial CT scan was done to determine presence of head injuries or tumors that could cause stroke (Davis, 2015).

• Explain why Mr. J was taking each of the medications prescribed at home.

Mr. J. was taking Lasix and Lisinopril to control BP, potassium chloride to boost his blood level, Neutral Protamine Hagedorn for diabetes, eye drops for glaucoma, and allopurinol for gout. He was using digoxin for atrial fibrillation, and aspirin for stroke symptoms (Davis, 2015).  

• Identify three high-priority nursing diagnoses based on Mr. J’s assessment, in accordance with Maslow’s hierarchy of needs.

High priority diagnoses for Mr. J. are breathing, mobility, and pain. He is at high risk of full-blown stroke because oxygen is not reaching the brain when blood vessels are blocked. The nurse should check his skin color, vital signs, restlessness and alertness, and administer oxygen as necessary. Mr. J’s mobility is limited because of the earlier episodes of TIA, and right hemiplegia and hemiparesis. The nurse put him under physiotherapy. Mr. J. has acute pain accompanied by numbness in his right body, and high BP that is causing him headache. The nurse should administer pain killers (Quizlet, 2015).  

References

Davis, C. (2015). Stroke: Click for Symptoms, Treatments, and Recovery. eMedicineHealth. Retrieved 3 December 2015, from http://www.emedicinehealth.com/stroke/article_em.htm

Mayo Clinic,. (2015). Symptoms and causes – Stroke – Mayo Clinic. Mayoclinic.org. Retrieved 3 December 2015, from http://www.mayoclinic.org/diseases-conditions/stroke/symptoms-causes/dxc-20117265

Quizlet,. (2015). How nursing care meets needs of Maslow’s hierarchy flashcards | Quizlet. Retrieved 3 December 2015, from https://quizlet.com/33127008/how-nursing-care-meets-needs-of-maslows-hierarchy-flash-cards/