Stroke Case Study (45 min)
Included In This Lesson
Study Tools For Stroke Case Study (45 min)
Outline
Mrs. Blossom is a 57-year-old female who presented to the Emergency Room with new onset Atrial Fibrillation with Rapid Ventricular Response (RVR). She is admitted to the cardiac telemetry unit after being converted to normal sinus rhythm with a calcium channel blocker (diltiazem). When you enter the room to assess Mrs. Blossom, her daughter looks at you concerned and says “mom’s acting kinda funny.”
What nursing assessments should be completed at this time?
You assess Mrs. Blossom to find she has a left sided facial droop, slurred speech, and is unable to hold her left arm up for more than 3 seconds.
What is/are your priority nursing action(s) at this time?
What may be occurring in Mrs. Blossom?
You call a Code Stroke and notify the charge nurse for help. You obtain suction to have at bedside just in case. The neurologist arrives at bedside within 7 minutes to assess Mrs. Blossom. He notes her NIH Stroke Scale score is 32. He orders a STAT CT scan, which shows there is no obvious bleed in the brain.
What are the possible interventions for Mrs. Blossom at this time?
What are the contraindications for thrombolytics like tPA (alteplase)?
You administer tPA per protocol, initiate q15min vital signs and neuro checks. You stay with the patient to continue to monitor her symptoms.
What are possible complications of tPA administration? What should you monitor for?
After 2 hours, Mrs. Blossom is showing signs of improvement. She is able to speak more clearly, though with a slight slur. She is still slightly weak on the left side, but is able to hold her arm up for 10 seconds now. Her NIHSS is now 6. Mrs. Blossom’s daughter asks you why this happened.
What would you explain has happened to Mrs. Blossom physiologically?
Two days later, Mrs. Blossom has recovered fully. She will be discharged today on Clopidogrel and Aspirin, plus a calcium channel blocker, with a follow up appointment in 1 week to see the neurologist.
What education topics should be included in the discharge teaching for Mrs. Blossom and her family?
aja -year off
Concepts Covered:
- Basics of Sociology
- Statistics
- Fundamentals of Emergency Nursing
- Factors Influencing Community Health
- Concepts of Population Health
- Studying
- Community Health Overview
- Developmental Considerations
- Microbiology
- Communication
- Legal and Ethical Issues
- Understanding Society
- Circulatory System
- Emergency Care of the Cardiac Patient
- Emergency Care of the Trauma Patient
- Emergency Care of the Neurological Patient
- Neurological
- Multisystem
- Medication Administration
- Emergency Care of the Respiratory Patient
- Health & Stress
- Delegation
- Cardiovascular
- Labor Complications
- Pregnancy Risks
- Newborn Complications
- Fetal Development
- Terminology
- Prenatal Concepts
- Newborn Care
- Labor and Delivery
- Postpartum Care
- Postpartum Complications
- Gastrointestinal
- Behavior
- Concepts of Mental Health
- Emotions and Motivation
- Growth & Development
- Intelligence and Language
- Psychological Disorders
- State of Consciousness
- Test Taking Strategies
- Note Taking
- Basics of NCLEX
- Substance Abuse Disorders
- Urinary System
- Nervous System
- Respiratory System
- Basics of Human Biology
- Concepts of Pharmacology
- Gastrointestinal Disorders
- Depressive Disorders
- Prioritization
- Anxiety Disorders
- Cognitive Disorders
- Eating Disorders
- Personality Disorders
- Psychotic Disorders
- Trauma-Stress Disorders
- Bipolar Disorders
- Psychological Emergencies
- Somatoform Disorders
- Peripheral Nervous System Disorders
- Cardiac Disorders
- Musculoskeletal Disorders
- Noninfectious Respiratory Disorder
- Central Nervous System Disorders – Brain
- Respiratory Emergencies
- Perioperative Nursing Roles
- Integumentary Disorders
- Disorders of Pancreas
- Neurological Emergencies
- Intraoperative Nursing
- Central Nervous System Disorders – Spinal Cord
- Shock
- Preoperative Nursing
- Vascular Disorders
- Postoperative Nursing
- Neurological Trauma
- Musculoskeletal Trauma
- EENT Disorders
- Prefixes
- Suffixes
- Proteins
- Med Term Basic
- Med Term Whole
- Basics of Mathematics
- Adult
- Basic
- Neonatal
- Pediatric
- Respiratory Disorders