Ischemic Stroke: A Case Study


ischemic stroke case study

Jul 19,  · Case presentation on ischeamic (Ischemic) stroke 1. Case Presentation on Ischeamic Stroke By: Kimberly Walsh SPT Sir John Golding Rehabilitation Centre Kingston Jamaica 2. – Anatomy – Definition – Epidemiology – Causes – Pathophysiology – Signs and Symptoms 3. Acute Ischemic Stroke Management Due to the results of the (European Collaborative Acute Stroke Study) ECASS‐III study, the AHA/ASA recommends that t‐PA can be used from 3‐ hours after patient was LSN and the CT. 2 Case Questions for Medical Nutrition Therapy: A Case Study Approach 4th ed. Title: Case 23 – Ischemic Stroke Instructions: Answer the questions below. You may print your answers or e-mail them to your instructor. Questions: 1. Define sdpintosa.tkbe the .

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Patient M is an active woman, 70 years of age, who lost consciousness and collapsed at home. Her daughter, who was visiting her at the time, did not witness the collapse but found her mother on the floor, awake, confused, and slightly short of breath. EMS evaluated Patient M, drew blood for a glucose level, and determined that she may have had a stroke. They notified the nearest designated comprehensive stroke center that they would be arriving with the patient within 15 minutes.

Patient M's daughter accompanied her. The triage and transportation of an individual with suspected stroke should be similar to that for an individual with ischemic stroke case study trauma, and treatment is recommended within 3 hours after the onset of stroke.

Because of the limited time available for assessment and diagnosis before optimal treatment, the EMS dispatcher should notify EMS personnel immediately and coordinate transport of the individual to the closest emergency facility, ischemic stroke case study, preferably one that is a designated primary or comprehensive stroke care center. On presentation in the emergency department, Patient M is immediately triaged.

Because Patient M is still somewhat confused, her daughter is asked to provide information on the patient's history. The daughter reports that her mother had had an episode of sudden-onset numbness and tingling in the right limb, with slight confusion and slurred speech, 3 days previously.

The episode lasted only 5 minutes, and Patient M had not called her primary care physician. Additional information provided by the daughter indicates that Patient M has been treated for hypertension for 10 years but notes that she is often not compliant with her antihypertensive medicine, a diuretic. The patient has never smoked, drinks occasionally, and is of normal weight. Patient M has two significant risk factors for stroke; one is a long history of hypertension.

Patient M's previous episode of numbness, ischemic stroke case study, confusion, and slurred speech appears to be evidence of a TIA, another substantial risk factor for stroke. In addition, the risk of stroke within 7 days is doubled for patients with TIAs who did not seek treatment. As is the case for many individuals who have a TIA, Patient M did not seek medical attention because the clinical symptoms resolved quickly.

She has pain in her left arm and a slight headache. There are slight carotid bruits on the right. The results of laboratory tests, including a complete blood count, prothrombin time, serum electrolyte levels, cardiac biomarkers, and renal function studies, are all within normal limits. There is an area of infarction in the right anterior hemisphere. There is no evidence of a subarachnoid hemorrhage. The diagnosis is made 2 hours after Patient M's arrival in the emergency department.

She is treated with intravenous rt-PA at a dose of 0. Many of the patient's symptoms, including her loss of consciousness, shortness of breath, pain, and headache, are nontraditional symptoms of stroke. Studies have demonstrated that nontraditional symptoms are more prevalent among women, often leading to a delay in the evaluation for stroke.

EMS personnel and clinicians should be aware of the potential for nontraditional symptoms in women and carry out a diagnostic evaluation addressing a suspicion of stroke. Antiplatelet therapy is not recommended as an adjunctive therapy within 24 hours of thrombolytic therapy. When Patient M's condition is stabilized, ischemic stroke case study, her primary care physician and consultant neurologist provide a referral for stroke rehabilitation, and a multidisciplinary rehabilitation team is formed to assess her rehabilitative needs, recommend the proper rehabilitation setting, and develop a treatment strategy tailored to her specific ischemic stroke case study that includes daily antiplatelet therapy.

The assessment also includes evaluation of the patient's risk for complications. The score on the Berg Balance Scale is 43, and Patient M does stop walking to engage in conversation.

Psychosocial assessment includes screening with the Center for Epidemiologic Studies Depression CES-D Scale, as well as review of the medical history and conversations with the patient and her children; no signs of depression are present. Patient M's score of 12 on the NIHSS falls within the range 6 to 15 that indicates she is likely to benefit from rehabilitation. Evaluating a stroke survivor's risk of complications is an important component of the overall assessment, and among the most common complications are falls, ischemic stroke case study, deep vein thrombosis, pressure ulcers, swallowing dysfunction, bladder and bowel dysfunction, and depressive symptoms.

In assessing the risk of complications, the Berg Balance Scale appears to be the most appropriate screen for patients who are likely ischemic stroke case study fall, ischemic stroke case study, and a score of less than 45 is associated with a likelihood of falling. The risk of a fall is also increased when a patient stops walking to talk, as Patient M did, during the Stops Talking When Walking test.

Signs of depression are subtle and may be vague. Several screening tools are available, but there is no universally accepted tool for use in the post-stroke setting. The CES-D was chosen in this case because it is easy to administer, is useful in older individuals, and has been found to be effective for screening in the stroke population, except for individuals who have aphasia.

The diagnosis of depression in stroke survivors should be based on sources in addition to a formal screening tool, such as a medical evaluation, patient self-report, observation of patient behavior, patient history, and staff reports of changes in behavior and motivation. The rehabilitation team discusses the results of the ischemic stroke case study with Patient M's daughter and son, both of whom live about 45 minutes away from the patient.

Together, the team and the family members explore options to determine the best approach to rehabilitation. A decision is made for Patient M to be discharged to an inpatient stroke unit, and a rehabilitation program is developed. The nurse on the team discusses the program with Patient M and her children and explains the course of rehabilitation and the expectations.

Rehabilitation will focus on an exercise program consisting of aerobic exercise, strength training, stretching, and coordination and balance activities.

Early initiation of rehabilitation is a particularly strong predictor of improved outcome, and rehabilitation in a stroke unit has been associated with improved quality of life, survival, ischemic stroke case study functional status at 5 years compared with a general healthcare facility. No studies have demonstrated the superiority of one rehabilitation setting over another, and the inpatient setting was chosen primarily to ensure consistent care, given how far away Patient M's children live, and the limited support she otherwise has for healthcare needs.

Decisions about the setting and program for rehabilitation should be shared with family members, and family and other caregivers should be provided with educational resources about the rehabilitation process.

The exercise program developed for Patient M is designed to help her regain the ability to independently carry out activities of daily living safely and to regain a functional ischemic stroke case study of ambulation. The benefits of an exercise program include increasing fitness, strength, and flexibility; improving function; preventing injuries and falls; and reducing the risk of recurrent stroke.

Patient M gradually resumes the ability to function independently, and after more than 2 weeks in the stroke rehabilitation unit, the score on the NIHSS has improved to 5.

Before she is discharged to her home, the rehabilitation team provides instructions for exercises to continue at home and recommends moderate physical activity as a secondary prevention measure. The team also educates Patient M about the importance of maintaining a normal blood pressure through use of her antihypertension medication and lifestyle modifications. This site complies with the HONcode standard for trustworthy health information: verify here.

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Ischemic Stroke Case Study | Stroke | Autonomic Nervous System


ischemic stroke case study


A Case of Acute Ischemic Stroke: Optimizing Management with Penumbra and Vessel Imaging. Acute ischemic stroke caused by distal left internal carotid artery Neuroprotective study agent. Ischemic stroke is the main cause of long-term disability for most of the people living in United States and ne of the main causes of death. The paper focuses on the pathology of ischemic stroke, risk factors, and clinical manifestations. The paper uses a Mr. Murray as the case study where through his experience with ischemic stroke, the paper. Introduction. This case study forms part of the Stroke Course History of Presenting Condition. Michael is a 61 year old Senior Partner in a Law Firm.