Nursing Case Study 5

__________________________Case Study Part 5:  Neurological_______________________________



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Clinical Course Day 7:  The patient was successfully extubated this morning at 0800 and is currently on oxygen via face mask at 2.5L/min. Vital signs are:  T 98.3, HR 96, R 21, BP 102/64, O2 Sat 97%. Pt is alert and oriented x 3. Pt able to carry on coherent conversation with medical staff. At 1005, the nurse arrives to discuss medications. The nurse notices that the patient appears to be asleep but when the patient is addressed,  it is noted that the left side of her face is drooping and patient is slurring her words. The nurse calls for assistance. Within ten minutes, the patient becomes more alert and her speech becomes less slurred. Within one hour, her sudden onset neuro findings have cleared.

Labs and Diagnostics:

Na 141 meq/L    K 3.8 meq/L     Cl 118 meq/L      HCO3 22 meq/L     BUN 58 mg/dL     Cr 3.1 mg/dL

WBC 11.0x 103/mm3   Hb 12.8g/dl  Hct 53%   BNP 701 pg/ml       Glucose 115


Carotid Ultrasound:

Mild stenosis of the right and left internal carotid artery (<50% stenosis in the range of 15-49%).

Based on the above information, answer the following questions:



18.)  Define Transient Ischemic attack (TIA) and the likely etiology [2 points].  Why is the diagnosis and treatment of TIA important? [2 points].





19.)  Name five risk factors Loretta has for Cerebrovascular Accident [5  points].







20.)  In addition to a carotid U/S, name and define 2 other diagnostic tests a cardiologist might order to evaluate Loretta’s neurovascular status? [3 points]







21).  List 5 of the guidelines developed by the American Heart Association and American Stroke Association Council on Stroke to reduce stroke risk specifically in women. (5 points)













APA 1 point         Scholarly Work  1 point           Total points 19