Assignment Task:
Task:
Assessment 3: Essay Length: 2500 words Weighting: 50% The purpose of these assessment is to provide you with the opportunity to demonstrate your understanding of the content and readings in Themes 4 and 5 and apply this theory to practice. In this essay on stroke, the participants will discuss assessment and management of stroke and how this will influence the ongoing management of the patient’s underlying neurological pathophysiology You are assigned to care for Mrs Jones, a 69?year?old female, who underwent coronary artery bypass graft (CABG) couple of days ago. During bedside handover from night staff, you noticed Mrs Jones had a facial droop. On assessment, she had right sided weakness and dysphasia. Her vital signs were: • temperature ? 35.8 • respiratory rate – 20 breaths/ min
• heart rate – 98 beats/min
• blood pressure ? 178/ 98
• blood glucose ? 12.5
• Glasgow coma scale – 14 (E4V4M6)
• body mass index? 32.9
• National Institute of Health Stroke Scale (NIHSS) score – 19.
Mrs Jones’s care was escalated. Urgent bloods and CT scan attended, and it was determined that Mrs Jones has left ischemic stroke. Aspirin 300 mg administered and was commenced on heparin infusion. Mrs Jones did not meet the criteria for IV tissue plasminogen activator (tPA). Her medical history includes type 2 diabetes for 25 years, hypertension and dyslipidemia. Her regular medications include insulin (LANTUS), atenolol, aspirin, SIMVASTATIN. Mrs Jones is non?smoker and rarely drinks alcohol. No significant family history . Refer to clinical guidelines for stroke management and use the essay format to structure your discussion. Address the following key points:
• discuss the initial nursing assessment and management in acute phase of stroke. Review the clinical presentation of left ischemic stroke and how they are reflected in Mrs Jones’s clinical findings.
• analyse the risk factors that contributed to Mrs Jones stroke. Describe the mechanism that links diabetes and stroke
• identify the appropriate approach to glycaemic management during acute phase of stroke
• describe the assessment and management of nutritional status for Mrs Jones
• discuss the immediate post? stroke complications and related nursing management to prevent further deterioration.
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