Reference no: EM133999820

Question

Ms Jones, a 66 year old women, awoke in the middle of the night and fell when she tried to get up to gob to the bathroom. She fell because she was not able to control her left leg Her husband took her to the hospital, where she was diagnosed with an acute right sided ischemic stroke (right middle cerebral artery stroke). Because she had awakened with symptoms, the actual time of onset was unknown, and she was not a candidate for tissue plasminogen activator (tPA).

Subjective data:

 Let arm, leg, and face are weak and feel numb.
 Feeling depression and fearful
 Requires help with activities of daily living.
 Is concerned about having another stroke.
 Has history of a brief episode of left sided weakness and tingling of face, arm, and hand 3 months earlier, which totally resolved and for which she di not seek treatment.

Objective data:

 BP 180/110mm Hg
 Left sided arm weakness and leg weakness.
 Decreased sensation on the left side particularly the hand
 Left homonymous hemianopsia.
 Alert, orientated and able to answer questions appropriately but has mild slowness in responding.

Past History:

 Migraines
 Hyperlipidemia
 Hypertension
 Smoking

Questions

1. What is tPA? How does it work and why could Ms. Jones not take it? If she was able to take it what health teaching would you have to provide?

2. How does Ms. Jones health history and current findings put her at risk for a stroke. Include pathological changes that that may have occurred.

3. How can the nurse address Ms. Jones concern regarding having another stroke?

4. Why would Ms. Jones ability to drive be affected after the stroke?

5. What strategies might the nurse use to help Ms. Jones and her family cope with her feeling depressed.

6. How will homonymous hemianopia affect Ms. Jones hygiene, eating, driving and community activities?

7. What factors should the nurse asses for related to outpatient.