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600 - Case Study Example

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George recently fell on the floor and taken to the hospital where he was diagnosed with ischemic stroke. His current medical diagnosis revealed…
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Nursing Management of patient with Ischemic stroke Insert Insert Nursing Management for a patient with physiological problems George Newman, a 70-year old man with medical history of stroke is currently on rehabilitation program to assist him in returning home. George recently fell on the floor and taken to the hospital where he was diagnosed with ischemic stroke. His current medical diagnosis revealed general weakness on his right side, with limited movements in his right leg, subsequently, his right arm and hand is regaining function and can only hold modified cutlery. His speech is generally slow with indication of forgetting some words, emotionally unstable and appears depressed. Often patients with ischemic stroke develop should be assessed for a wide variety of medical physiological symptoms. Recent literature suggests that one of the greatest predisposing factors to ischemic stroke often related to cardiac problems and diseases; which as a result give rise to characteristic neurological problems.
Pathophysiology
Symptoms of ischemic stroke varied and attributed to many factors. As Feigin (2005) points out, one or more of the observed risk factors may increase the chances of development of the disease, for most patients, there is no sure sign that a stroke would occur.
Subsequently, Bharucha et al, (1988) also claimed that the most common risk of stroke is family history and age. Other studies also suggests that other important predisposing risk factors to the disease include, patients with high blood pressure, which has since then been reported in 70% of medical patients, high level of cholesterol in blood, frequent cigarette smoking, diabetes mellitus, obesity, cardiovascular diseases in patients with history of occurrence of heart attack, vascular malformation and alcoholics. (American Heart Association, 2009)
Equally, Sridharan, (1992) notes that acute stroke is a severe disease and as such 40% of the patients with stroke especially in acute stage often develop symptoms that are associated with speech difficulties or even difficulties in food swallowing experienced in varying degrees. George’s diagnosis revealed that he had speech related problems that could explain why his stroke would were at an acute stage and such fell into a coma. Despite these physical complications resulting from damage to brain tissue, other resulting complications cause by stroke include constipation, blood clot formation in the lower limbs, depression, pressure sore, swallowing disorders among others.
Besides looking at the clinical symptoms characteristic of the disease, an examining doctor will look at the presence of predisposing risk factors of the disease including the level of blood pressure, blood sugar level, and level of cholesterol in blood. Additionally, blood samples to determine the level of hemoglobin, platelets level and the time taken for blood to clot, blood viscosity and the tendency of the bleeding. Other detailed examination done to check the occurrence of heart attack through an electrocardiogram test.
Modern treatment programs focus on disease prevention and rehabilitation programs early enough after disease diagnosis. At George’s acute stage of disease development, prescription medication include anti-platelet form of drugs to prevent blood clotting, anti-coagulants and thrombolytic agents. George’s current medication consists of Clopidogrel, Simvastatin, Lisinopril and Escitalopram. However, surgery also recommended for ischemic stroke patients to eliminate sections of intima in carotid artery to reduce stroke recurrence. Additionally rehabilitation programs restore a patient to the normal daily functions through self-adaptation achieved through collective responsibility of medical providers and family members.
References
American Heart Association. (2009). Heart Disease and Stroke update. Dallas, Texas.
Bharucha, N., Bharucha, E., & Bharucha, A. (1988). Case-control study of completed ischemic stroke in the Parsis of Bombay: a population-based study. Neurology 38 , 490-2.
Feigin, V. (2005). Stroke epidemiology in developing world. Lancet 365(9478) , 2160-1.
Sridharan, R. (1992). Risk factors for ischemic stroke: a case control analysis. Neuroepidemiology 11 , 24-30. Read More
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