Ischemic Stroke Nursing Case Study

Ischemic Stroke Nursing Case Study-26
He asks the case manager to meet with Lucinda, and then with Mario when he is fully conscious.

He asks the case manager to meet with Lucinda, and then with Mario when he is fully conscious.

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Also known as cerebrovascular accident (CVA), stroke occurs when part of the brain is deprived of adequate oxygen due to an arterial blockage or rupture.

It accounts for more than 160,000 annual deaths in the United States, making stroke the third leading cause of death, following closely behind heart disease and cancer. There are two kinds of CVAs or stroke: an ischemic stroke (occurs when the blood supply to the brain is interrupted, usually by a blood clot) or a hemorrhagic stroke (happens when there is bleeding in or around the brain).

She explained that although he had tried to quit several times, he had trouble abstaining for longer than a week.

Also noted in Mario’s medical history was that he led a sedentary lifestyle that had contributed to his excess weight.

Lucinda feels somewhat relieved and tells the nurse and attending ER physician that both of Mario’s parents passed away from myocardial infarctions when they were in their late 60s.

She adds that Mario is a smoker, usually smoking about a pack and half each day.Background: An 83-year-old woman with a history of hypertension and dyslipidemia developed acute onset of impaired speech and comprehension, and right-sided weakness.Her previous medical history was notable for hyperthyroidism and a curative remote mastectomy for breast cancer.Lucinda realizes that Mario meets the criteria for all of them.The ER physician advices Lucinda that Mario will need to undergo stroke rehabilitative therapy, and that he is going to refer him to a cardiologist, nutritionist, and psychiatrist, and then discusses the case with the ER case manager.He disliked physical activity and his idea of “exercise” was watching sports on television. When the nurse asks the wife if he had experienced any unusual symptoms prior to being admitted to the hospital, she tells her that Mario had complained of escalating migraines a couple of days ago.But she tells the nurse that this was not unusual since Mario had suffered migraines ever since his late thirties when he immigrated to the United States from his native Puerto Rico.Initial examination showed global aphasia, right homonymous hemianopia, right hemiplegia, and hemisensory loss. Saver is Principal Investigator of the NIH FAST–MAG Trial, is an investigator in the NIH MR RESCUE, IMS 3 and CLEAR trials, is on the Scientific Advisory Board and Speaker's Bureau for Boehringer Ingelheim (secondary prevention) and has received speaking honoraria from Concentric Medical. Please see our Commenting Guide for further information.Investigations: Physical examination, laboratory tests, noncontrast head CT scan, multimodal brain MRI scan, catheter cerebral angiogram, echocardiogram, continuous cardiac monitoring. Buck is supported by a fellowship award from the Heart and Stroke Foundation of Canada. We reserve the right to remove posts at our sole discretion.In some instances, people may also experience a “mini-stroke” (or transient ischemic attack), where symptoms only last for a short period of time. Upon Mario’s arrival to the hospital, the ER nurse proceeds to gather the patient’s medical history from his wife, Lucinda, who accompanied him in the ambulance.She tells the nurse that Mario has a history of uncontrolled hypertension (and he was often non-compliant with his anti-hypertensive medications).


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