Nursing: Strokes, Essay Example

Personal and Medical history

Personal history

Mr. P.J arrived at the clinic for his regular checkup after having had a cardio vascular accident (CVA) three years ago. Cardio vascular accident (CVA) or stroke is an intense loss of brain function due to depleted blood supply to that section of the brain. It could be due to hemorrhage; thrombus or arterial embolism (Mackenzie, 2011). Mr. P.J’s stroke (CVA) was caused by an embolus. He is an African American, 56 years old and police officer for 30 years; father of six boys and grandfather of three girls.His active participation in sports as an athlete since a youth from high school has always been one of the highlights of his life besides enjoying a wonderful career as a police officer; Mr. P.J’s wife who accompanies him on his clinic visits expressed how he is a wonderful husband and provider for his family.Both of his parents are still alive and healthy. His mother is 83 years old and father 85. Mr. P. J is the fifth of eight children in the family.

Medical history

The onset of his stoke was sudden when Mr. P.J realized that he was not seeing. Apart from those symptoms, he experienced difficulty in speaking along with loss of coordination and balance with weakness on the left side. Mr. P.J was hypertensive for more than 10 years and type 11 diabetic for 15 years. There were also fluctuations in the cholesterol levels for the past four years. He was overweight; CT scan revealed a thrombus at time of initial stroke attack. Muscles were still responding weakly at time of visit (Lee, Hong & Saver, 2010).

Drug therapy and treatments

Modern stroke intervention focuses on removing the blockage through thrombolysisor thrombectomy. It has been proven through extensive research that rapid stroke intervention was hypothesized asTime is Brain during the early 1990s.Number of years later, this same medical philosophy has been used to save the life of many stroke patients. The premise of rapid restoration of cerebral blood flow reducing death of brain cells since has been scientifically proved to be valuable stroke treatment strategy. Further, studies proved that attempting to lower blood sugar and pressure levels were not very effective in restoring blood flow to the brain. Consequently the priority in stroke management is enhancing blood flow to the brain(Kelly, Brady & Enderby, 2010).

Specific drug therapy in thrombotic CVA for which Mr. P.J is diagnosedconsists of tissue plasminogen activator (t-PA).These drugs are dispensed as alteplase, reteplase, and tenecteplase (TNKase). Usually, administration begins after three hours of onset of sings and symptoms. Does of plasminogen activator (t-PA) vary according to the severity or complexity of the presentation. A strict blood clotting time is maintained during admintration of this drug (Tansy & Liebeskind, 2013).

Follow up

Follow up of stroke management includes continual rehabilitation therapy if limbs are still weak after discharge. Depending on the extent of nerve damage balance support may be necessary in which case appropriate assistive devices were given to Mr. P.J. Regular blood sugar, pressure and cholesterol evaluations are done to avoid further stroke incidences. Patient education regarding diet, exercise and weight loss is a mandatory follow up education program.

References

Kelly, H. Brady, M., & Enderby, P. (2010). Speech and language therapy for aphasia following stroke. Cochrane Database Syst Rev (5); CD000425.

Lee, M. Hong, K., &Saver, J. (2010). Efficacy of intra-arterial fibrinolysis for acute ischemic stroke: meta-analysis of randomized controlled trials. Stroke 41 (5): 932–7.

Mackenzie, C. (2011). Dysarthria in stroke: a narrative review of its description and the outcome of intervention. Int J Speech Lang Pathol, 13 (2); 125–36.

Tansy, A., & Liebeskind, D. ( 2013).The Goldilocks Dilemma in Acute Ischemic Stroke. Frontiers in neurology 4: 164.