Case Study Essay Name University Assessment 1: Case study essay Scenario You, the registered nurse, are working in the intensive care unit of a regional hospital. The patient you are delivering nursing care to is a 32 year old female patient by the name of Joanne…
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In your essay you need to: Introduction The nurses in the intensive care unit have extensive roles and duties upon them that have to be performed with great precision and care. The management of the brain dead patient and his family is a very important part of the duty of intensive care unit nurses and extensive knowledge with regard to this subject is needed for the nurses to have expertise in this management. Accurate skills and knowledge are required by a nurse to assess a patient as being brain dead. The nurse should be able to effectively differentiate between brain death and cardiac death and should be able explain to the family that brain death is a condition which cannot be reversed. She should also possess skills to counsel the family to allow for the organ donation of their patient. It is also the duty of the nurse to provide care to the patient so that his organs may be preserved for harvesting. The case of Joanne is also similar who is a brain dead patient in the intensive care unit. Joanne has suffered from a ruptured berry aneurysm. A ruptured berry aneurysm is a common cause of haemorrhage in the brain and it is associated with a mortality rate of 50% (Yachnis and Rivera-Zengotita 2013). Her family is on their way and it is the nurse who has to manage the family upon the arrival. The nurse should inform the family regarding the situation of Joanne and provide support to the family. At the same time the family should also be counselled for approval for organ donation. Pathophysiology of Berry Aneurysm A berry aneurysm is a point where a blood vessel in the Circle of Willis is weak and dilated. This weakness is mainly due to shortcomings in the proper formation of an artery, particularly at the points where they divide. The arteries at the weak points in the aneurysms only comprise of endothelium and an adventitia. The elastic lamina is not developed and the other muscular layers are also not structurally well formed. A rise in the intravascular pressure at these points results in further dilatation which leads to rupturing of these aneurysms (Rubin and Reisner 2009). The anatomical location of a berry aneurysm is mostly at the meeting point of the posterior communicating artery and the internal carotid. The other common site is where the anterior communicating artery joins with the anterior cerebral artery. The point at which the middle cerebral artery bifurcates is also a probable location of the berry aneurysm. In 15% of the patients there is more than one aneurysm. A genetic role in its causation is also known and it is believed that these aneurysms run in the family. Berry aneurysms are also known to co-exist with other pathological conditions which include Ehlers-Danlos syndrome as well as polycystic kidney disease and coarctation of aorta (Longmore 2007). Berry aneurysms have a greater predisposition for females as compared to males. They mostly rupture between the age of 55 and 60 years but early ruptures are also possible. The rupturing of this aneurysm can lead to bleeding in the subarachnoid space, within the brain tissue or in the ventricles of the brain. The main symptom following rupture that is presented by the patient is a headache of very severe intensity and the patient describe it as the “worst headache of life.” This is due to the subarachnoid haemorrhage. Also the patients who survive have a risk of having a vasospasm between the fourth and the fourteenth day of the
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(Case Study Essay: Joanne Ruptured Berry Aneurysm, Intracerebral Essay)
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