Cognitive and Neurologic Function
Mr. J’s wife, a 77 year old woman, reported that approximately 3 days ago Mr. J stopped taking his blood pressure medications (lisinopril and furosemide) because he had spent the money in a horse race. two nights ago he started to experience more frequent numbness of the right arm and slurred speech, but she didn’t think it was important because it disappeared after several hours. today she had difficulty waking him up, and her daughter told her to call the ambulance.
Mr. J’s blood presssure on admission was 220/120mm Hg; his heart rate was 126 beats/min; respiratory rate was 28breath/min; and temperature was 98.9 degrees.he had right-sided hemiparesis and hemiplegia. his speech was slurred and at times incomprehensible. Mr. J was able to maintain his airway at this time.
Oxygen via nasal cannula is started at 2 L/min, and a peripheral intravenous line is started with normal saline intravenous fluid therapy at 80 mL/hr. A 12-lead ECG is performed, and Mr. J is sent for a CT scan of the head
Which one of Mr. J symptoms supports a diagnosis of stroke?
What are the risk factors Mr. J presents for the development of stroke?
Indicate the type of stroke Mr. J most likely had, and support your answer.
What evidence is presented to support the Mr. J had experienced previous TIAs?
Why is atrial fibrillation a risk factor for embolic stroke?
Explain the rationale for each of the interventions conducted for Mr. J.
Explain why Mr. J was taking each of the medications prescribed at home.
Identify three high-priority nursing diagnosis based on Mr. J’s assessment.
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