Early Management of Acute Cerebrovascular Accident

What Additional Subjective Data Do You Think the Patient Will Share?

1. Past similar symptoms and causes of pain;
2. Reactions to medications used;
3. Family history of hypertension;
4. Lifestyle preferences, including physical activities, diet, and obesity factors (Dunphy, Winland-Brown, Porter, & Thomas, 2015);
5. Smoking or drug history;
6. Risks of diabetes or cardiac diseases.

What Additional Objective Data Will You Be Assessing for?

1. Memory impairment;
2. Changes in speaking or writing;
3. Visual problems;
4. ECG results to assess heart sounds;
5. Hemiplegia development (Wist, Clivaz, & Sattelmayer, 2016);
6. Headache worsening.

What National Guidelines Are Appropriate to Consider?

Regarding the symptoms and complaints of the patient, he has a stroke. Several national guidelines can be offered for effective management of care for patients with a stroke. For example, American Heart Association and American Stroke Association (2013) introduce effective guidelines focusing on early care, education, and classification. Royal College of Physicians (2016) develops another strong guideline that can be used by clinicians worldwide. Both guidelines are helpful tools for the medical staff and patients.

What Tests Will You Order and Explain Your Rationale for Your Orders?

In addition to physical examination, the patient should take the following tests (Manners, Steinberg, & Shutter, 2017):

1. Several blood tests to identify possible blood clots and the level of sugar or other harmful chemicals;
2. CT to identify brain damage if any;
3. MRI to obtain a detailed picture of the brain;
4. Echo to have the information about the heart of the patient.

Will You Be Looking for a Consult?

A consultation with a cardiologist is recommended to check the condition of the heart. In addition, communication with a neurologist is obligatory to interpret the results of brain images and develop a treatment plan.

What Are the Medical and Nursing Diagnoses?

Nursing diagnoses: headache, impaired physical mobility, and disturbed sensory perception.

Medical Diagnoses: stroke, migraine, hypertension, myocardial infarction.

Are There Any Legal/Ethical Considerations?

Regarding the condition of the patient and his little confusion, it is necessary to inform his family about the case in order to gather enough relevant information about the patient.

What Is Your Plan of Medical/Nursing/Complementary Care?

A nursing plan of care: monitor vital signs, check blood pressure and heart rate, and report on changes in vision, walking, or speaking in order to decrease negative outcomes and the spread of physical changes and improve the general condition of the patient.

A medical plan of care: the patient should be treated with drugs like aspirin to reduce the outcomes of a stroke. In case blood clots are proved, they have to be removed mechanically.

Complementary therapies for patients with a CVA may include acupuncture to improve motor function (Caruana, 2015). The improvement of lifestyle and properly organized physical exercises may be rather helpful.

Are There Any Healthy People 2020 Objectives that You Should Consider?

There are several Healthy People 2020 objectives for consideration in this case. First, the improvement of cardiovascular health is required through prevention and detection of the risks at their early stages. Hypertension is a serious health problem for the patient. Healthy People 2020 objectives promote an idea of proper management of care for patients with hypertension and free screening for adults.

Using the Circle of Caring, What or Who Else Should Be Involved to Truly Hear the Patient’s Voice, Getting Him and His Family Involved in the Care to Reach Optimal Health?

Using the Circle of Caring, it is possible to involve several groups of people to hear the voice of the patient and reach optimal health outcomes (Dunphy et al., 2015). The assessment of the physical condition of the patient should be developed by a primary care provider. In addition, family members have to be involved to gather enough information about the past medical history of the patient and the family history. The collaboration of nurses and doctors is obligatory because properly identified nursing diagnoses help to develop a correct medical diagnosis and began treatment. Referrals and education of the patient should not be neglected.

References

American Heart Association and American Stroke Association. (2013). AHA/ASA guideline: Guidelines for the early management of patients with acute ischemic stroke. Web.

Caruana, J. (2015). The effectiveness of acupuncture in motor function recovery during cerebrovascular accident rehabilitation. Web.

Dunphy, L., Winland-Brown, J., Porter, B., & Thomas, D. (2015). Primary care: The art and science of advanced practice nursing (4th ed.). Philadelphia, PA: F.A. Davis.

Manners, J., Steinberg, A., & Shutter, L. (2017). Early management of acute cerebrovascular accident. Current Opinion in Critical Care, 23(6), 556-560.

Royal College of Physicians. (2016). National clinical guideline for stroke. Web.

Wist, S., Clivaz, J., & Sattelmayer, M. (2016). Muscle strengthening for hemiparesis after stroke: A meta-analysis. Annals of Physical and Rehabilitation Medicine, 59(2), 114-124.