Answer To: Assessment Task 1b: Case Study Application of health assessment, planning, implementation and...
Insha answered on Apr 22 2022
Assessment Task 1b: Case Study 1
Assessment Task 1b: Case Study
Assessment Task 1b:
Case Study
Table of Contents
Q.1 4
A definition 4
Causes 4
Clinical manifestations 4
Typical initial management 5
Q.2 5
Swallowing Dysfunction, Fever, and Hyperglycemia 5
Acute Ischemic Stroke Complications 6
Q.3 7
Communication review 7
Checking settings and modes of ventilators 7
Suction appropriately 8
Q.4 8
Mode of action 8
Indications 8
Nursing administration 9
Assessments 9
Interventions 9
Teachings 9
Adverse effects 10
Contraindications 10
Q.5 10
Q.6 11
References 12
Q.1
A definition
The vast majority of strokes (87%) develop when blood arteries to the brain constrict or get blocked with fatty deposits known as plaque. An ischemic stroke is a stroke caused by a shortage of blood reaching a portion of the brain. Ischemic stroke is caused by high blood pressure, which is a major risk factor (Reddy et al. 2020).
Causes
It is usually caused by a blood clot in the brain that plugs or blocks a blood vessel. This prevents blood flow to the brain. Brain cells begin to die within minutes. A stenosis, or narrowing of an artery, is another reason. This can occur as a result of atherosclerosis, a condition in which plaque forms inside the arteries. When the blood supply to the brain is suddenly disrupted, transient ischemic attacks (TIAs) occur (Kuriakose, & Xiao, 2020). In case of Robert, he is not a candidate for thrombolytic management, which means he doesn’t have large blood clots and just need acute treatment on time.
Clinical manifestations
There is a need to gather information and establish a diagnosis of Mr. Robert and his stroke or TIA (transient ischemic attack). Doctors and nurses need go over the events that have transpired and will:
• Inquire as to when the stroke symptoms began. According to the wife the symptoms began right after he woke up in the morning.
• Ask a family member for a medical history. Robert had had a previous ST-elevation Myocardial Infarction (STEMI) 5 years ago, which was followed by hypercholesterolemia, Left Ventricular Failure (LVF), and hypertension. Bisoprolol, Enalapril, Aspirin, and Furosemide are used to treat these conditions. He has no allergies that are known to him.
• Doctors performed a physical as well as a neurological assessment and obtained specific laboratory (blood) testing. Also, Have his brain scanned using a CT (computed tomography) or MRI (magnetic resonance imaging) scan (Dichgans, Pulit, & Rosand, 2019). Robert's first ECG indicates that he has Atrial Fibrillation, which is not typical for him. “His vital signs show significant hypertension (165/96) and an altered state GCS of 12 at the moment.” C - reactive protein (CRP) tests, Cardiac Markers, Coagulation Studies, Initial Urea & Electrolytes, Full Blood Examination, and Glucose tests have been submitted to pathology, and the findings have been normal thus far.
Typical initial management
When a stroke occurs, the health-care team provides prompt treatment. The objective of immediate therapy is to minimize brain harm. This is accomplished by promptly restoring blood flow to the area of the brain where the blockage occurred. Ischemic stroke is treated with a clot-busting medication called alteplase (IV r-tPA) (Hui, Tadi, & Patti, 2018). It can lessen the effects of a stroke by dissolving a blood clot that is blocking blood flow to the brain.
Q.2
Nurses are supposed to conduct thorough and systematic physical examinations on all stroke patients, including monitoring the five vital signs. "Patients should get stroke nursing care consistent with best practice regardless of whatever hospital unit they are admitted to if a specialist stroke unit is not available" (Tanz et al. 2019).
Swallowing Dysfunction, Fever, and Hyperglycemia
For all stroke patients, monitoring of dysphagia, body temperature, and blood glucose is considered standard of care."According to data from the Australian Stroke Foundation's national stroke audit, less than half of patients with fever (48 percent) got paracetamol /acetaminophen within an hour" (Okoth et al. 2020). The adoption of the swallowing (FeSS) clinical guidelines, fever, sugar guidelines for the management of swallowing dysfunction, fever, and hyperglycaemia dramatically decreased mortality and dependence, according to the QASC study (Quality in Acute Stroke Care) (Shan et al. 2020).
For stroke therapy, FeSS procedures are currently strongly recommended by Australian clinical recommendations. In this case, who have had an ischemic stroke, intensive therapy for hyperglycaemia is not suggested. On admission to the hospital, nurses should examine the swallowing condition of Robert as soon as feasible following a stroke.
Acute Ischemic Stroke Complications
For patients, managing, recognizing, anticipating, and preventing possible post stroke medical consequences is critical. No modifiable predictors are responsible for up to 70% of early fatalities and poor outcomes. The most important factors are the severity of the stroke at the time of admission, age, and pre-stroke impairment (Yuan, Chen, &...