Nursing Care Practices For The Management Of Embolic Stroke - Samples

Question: Discuss about the Nursing Care Practices For The Management Of Embolic Stroke. Answer: Introduction The current assignment focuses on thenursing care practices for the management of Embolic stroke. Embolic stroke could be referred to the condition when a blood clot which forms elsewhere in the body travels to the brain via the blood stream. It blocks the adequate supply of blood to the brain leading to ischemic stroke. This cuts off the required amount of oxygen and nutrients from reaching the brain. Some of the factors which further increase the chances of contraction of the disease are- being over 40 years of age, possessing autoimmune disease such as diabetes, presence of heart disease (Holmes Jr et al., 2015). Cerebrovascular accidents (CVA) are one of the biggest killers in Australia. It has been found that 80% of the strokes could be prevented which in turn adds up to a sufficient amount of healthcare costs (Mozaffarian et al., 2016). Therefore, effectivenursing care could be designed for control and management of the condition of the patient. The assignment discusses in deta il the efficacy of evidence based pharmacological intervention methods. Patient background In the current assignment we have focussed upon medication management and nursing care for embolic CVA. For designing of an effective care management the patient background needs to be taken into consideration (Hart et al., 2014). Here, the patient was a 58 year old man named John who had been brought and admitted to the hospital on grounds of feeling numbness in his rights hands along with speech difficulty and light headedness. He worked as a construction site engineer with Quality enterprises and solutions located in the Osborne region of New South Wales. As reported by his family John had normally reported to work for the day. However, he started feeling uncomfortable in the afternoon and was unable to work till he started feeling dizzy and had numbness in his right arms. Later he was admitted the daffodils hospital on encountering blurred vision, slurred speech. Reason for admission John had been feeling dizzy at his place of work and had difficulty in breathing. He later on developed slurred speech and blurred vision which made work difficult for him. His fellow workers felt that he needed immediate medical intervention and got him admitted to the hospital. John was immediately attended by a resident doctor. He reported that John had poor pulse rating, high BP along with slow breathing. The patient also reported signs of face muscle twitching along with slurred speech. Therefore, based upon these symptoms he was shifted to the medical examination room. Diagnosis Based upon the range of a number of clinical symptoms such as slurred speed, blurred vision, numbness in the right hands which gradually spread to the entire arm along with face muscle twitching and dizziness, John was suspected of embolic stroke. The tool used in order to access the condition of the patient was the FAST framework. Here, FAST stands for face, arms, speech and time. Here, the patient exhibited constant face muscle twitching along with difficulty in raising both his arms straight. Therefore, the preliminary diagnosis was given that the patient might be experiencing an embolic stroke. Therefore, the patient was suggested a blood test a along with CT scan. The CT scan confirmed the presence of ischemic stroke in the penumbra region of the brain. Past medical history The diagnosis of the past medical history of the patient plays a crucial role in the designing of effective care treatment for the patient. Here, John had a past history of hypertension and high blood cholesterol. On further investigations, it was found that he had previously fallen unconscious in his place of work an had to be given artificial oxygen. Therefore, based upon the past history of hypertension the patient was put under emergency care for embolic stroke symptoms management and prevention. A-E assessment of the patient with expected findings typical of embolic stroke An A-E assessment of the patient was conducted for analysing the physical condition of the patient. Here, A refers to airway, B for breathing, C for circulation, D for disability and E for exposure. Attributes Effects A- Airway The patient had difficulty in breathing stressing upon the need for mechanical ventilation. Once the airway had been inserted into the patient the see-saw movement of the chest stops in the patient. B- breathing The patient recorded SpO2 level of 84% which is comparatively low whereas the normal SpO2 is expected to remain somewhere between 94% to 99% .The falling of the SpO2 level below 84% point towards the administration of artificial oxygen support. C-circulation The patient recorded high blood pressure along with difficulty in breathing. D-disability The patients had slurred speech and difficulty in talking. He could only answer to the inquiries made by the doctor by making eye gestures. E- exposure The patient further recorded temperature around 38.2 degree centigrade which was slightly higher than the normal. Preliminary diagnosis: The patient could be suffering from an embolic CVA. Pharmacological treatment for embolic stroke The pharmacological treatment for stroke could be divided into- stroke-specific treatment and stroke prevention. As commented by Ruff et al. (2014), the treatment process further varies depending upon the nature of the stroke whether it is ischemic or hemorrhagic. Some of the pharmacotherapeutic options are tissue plasminogen activartor (tPA) and antiplatelet agents. It was found that the ones receiving tPA were more likely to have minimal or no disability after several months of treatment (DeBaun et al., 2014). Anti platelet agents such as aspirin have been found to be effective for the treatment of acute ischemic stroke. The aspirin therapy should begin within 24-48 hours of the acute ischemic stroke (Berkhemer et al., 2015). The secondary treatment addresses the prevention of recurrences of the symptoms of stroke by controlling some of the metabolic risk factors namely blood pressure and lipids. The use of diuretics along with angiotensin converting inhibitor enzyme has been seen to be beneficial. Evidence based rationale for medication and nursing care The medication provided for the management of the conditions of embolic stroke could be justified with the help of a number of supportive theories and arguments. Evidence based approaches have proved that revasculiarization of the ischemic brain and arousing sleep neurons can improve outcomes in patients with acute stroke (Campbell et al., 2015). The two major drug classes used over here are thrombolytic and antiplatelet agents. Currently one of the approved drugs which are used is tissue plasmionogen activator (t-PA) alteplase, which results in reperfusion by dissolving the thrombus (Saver et al., 2016). The affectivity of the drug supplied depends on the effectiveness of delivery to the damaged channel. As supported by Diener et al. (2015), if tPA is administered within three hours of onset of stroke improved functional outcome is observed. As supported by Schnenberger et al. (2016), administration of low molecular weight heparins have been further seen to lower the risk of thrombo cytopenia or osteoporosis in the patient. tPA has been rated as the Gold standard for the treatment of ischemic cerebral stroke. It works by dissolving blood clot and improving the flow of blood to the brain. As reported by Doucet, Roncarolo, Tampieri del Pilar Cortes (2016), patients who have got tPA administration on time have been seen to recover better than the one who had not received the drug therapy at the right time. The after treatment could be started with the right doses of administration of anticoagulants. The anticoagulants have been seen to interfere with the blood capacity to clot (Nikoubashman et al., 2017). Therefore, improving the supply of blood to the brain and can be used an effective preventive measure. In this respect, the chances of recurrence are most common in the patient within 90 days of suffering a first stroke. Therefore, in order to control the rate of the fatalities it is necessary to put the patient on anti-coagulants. In this respect, employment of trainednursing professionals trained in the areas of acute stroke management could be beneficial. Additionally, using frameworks such as Fast can r help the nurse analyse the condition of the patient. As mentioned by Anderson, Saleemi Bialystok (2017), effective record keeping and documentation has also been seen to enhance the process of drug delivery and monitoring in the patients. However, the nursing professional should ensure that permission have been sought from the respective family members of the patients before putting them through any aggressive care procedures. Conclusion The current assignment focuses on the concept of nursing care provision and management for embolic stroke. The patient has suffered an embolic stroke and had to be provided immediate care provision and management. In this respect, effective caution needs to be practised regarding the administration of the medications to the patient. For the preliminary examination of the condition of the patient a FAST framework was followed. Form the diagnosis it was ascertained that the patient could be having an embolic stroke. Hence, the patient was put under further blood tests and CT scan, which confirmed the presence of Embolic stroke in the patient. The assignment also discusses the effectiveness of different medications. Some of these have been discussed with regards to the rate of success in controlling the progression through the condition of embolic stroke. More emphasis had been given to tPA administration which if provided within a particular time frame can reduce the severity of the st roke References Anderson, J. A., Saleemi, S., Bialystok, E. (2017). Neuropsychological assessments of cognitive aging in monolingual and bilingual older adults.Journal of neurolinguistics,43, 17-27. Berkhemer, O. 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