Before answering this question, review the client’s health information in the EHR. Identify if each finding is consistent with a cerebrovascular accident or transient ischemic attack. Select one or more options in each row.
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Vignette #1: A 77-year-old woman was cooking in the kitchen when she collapsed onto the floor. Her daughter called an ambulance, and the woman was taken to the emergency room. She had suffered a stroke and slowly regained consciousness over the next two days. However, when she woke up, she had the following signs and symptoms: loss of sight (although pupils were reactive to light), partial amnesia (loss of memory), inability to create and store new long-term memories. Vignette #2: A 61-year-old business executive with a long history of high blood pressure collapsed while jogging over the lunch hour. His jogging mate quickly contacted a police officer who helped carry the man to a hospital just down the road. At the hospital, an MRI was performed that revealed a blockage of a major cerebral artery and ischemic changes to the portion of the brain supplied by that artery. With quick medical attention, the man was stabilized, and he slowly improved over the next three weeks. The following signs and symptoms did persist, however: weakness of the facial and upper extremity muscles on the left side, loss of sensory discrimination when objects are placed into the left hand, significant mood and character changes.
Dominador T.
74-year-old male with a history of hypertension and smoking, is having dinner with his wife when he develops sudden onset of difficulty speaking, with drooling from the left side of his mouth, and weakness in his left hand. His wife asks him if he is all right and the patient denies any difficulty. His symptoms progress over the next 10 minutes until he cannot lift his arm and has trouble standing. The patient continues to deny any problems. The wife sits the man in a chair and calls 911. The EMS squad arrives within 5 minutes. Upon arrival in the ED, patient's blood pressure was 178/94, pulse 78 and regular, PaO2 97% on room air. Neuro exam - Cranial nerves- Mild left facial droop. Motor- Right arm and leg extremity with 5/5 strength. Left arm cannot resist gravity, left leg with mild drift. Sensation intact. Neglect- Mild neglect to left side of body. Language- Expressive and receptive language intact.Mild to moderate dysarthria. Able to protect airway.examine a case study and analyze the symptoms presented. identify the elements that may be factors in the diagnosis, and you explain the implications to patient health.explain the following:3 . Both the neurological and musculoskeletal pathophysiologic processes that would account for the patient presenting these symptoms.
Adi S.
Mr. Q, age 64 years, developed a severe headache several hours ago that has not responded to acetaminophen, rest, cold packs, or NSAIDs. Now his speech is slurred, and his right arm and the right side of his face feel numb. His wife reports that he "looks funny," and his face is "half dead." He is very anxious and is transported to the hospital. Mr. Q has a history of smoking and arteriosclerosis, and there is a family history of CVA and diabetes. Assessment at the hospital indicated weakness on the right side, including facial asymmetry and a blood pressure of 220/110 mm Hg. A CT scan showed damaged tissue on the left side of the brain, and an angiogram indicated narrowing of the carotid arteries and middle cerebral arteries, with occlusion of the left middle cerebral artery. It was determined that Mr. Q is likely experiencing a CVA. Case Study 1 Questions: 1. Describe the three causes of CVAs and the characteristic onset signs and symptoms associated with each. What do you think is most likely in this case?
Bryan V.
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