You walk into Tyler End’s room on initial rounds and find Mrs. E in tears. She says, “He is having such a rough time, I wonder if I’ll ever have the same man back.” You heard in report that T.E. is a 63-year-old man who, while at breakfast with his wife, developed slurred speech, became severely confused, and collapsed to his R side. The acute episode began resolving in approximately 15 minutes while en route to the ED. Mrs. E was almost hysterical because her husband had had 2 episodes of “being revived from sudden cardiac death” 5 years ago. A CT scan revealed an acute L middle cerebral aneurysm (frontal/parietal) stroke. Heparin therapy was started right away and the next day an angiogram revealed high grade L carotid artery stenosis with very stagnant flow. The heparin was discontinued, and he was taken to the OR for a carotid
endarterectomy.
1. What things would you anticipate finding during your baseline neurologic exam?
2. What assessment of the spouse does the nurse make? What measures could be taken to help her or should be suggested to her?
3. What is the difference between a carotid endarterectmy and a carotid angioplasty?