Comprehensive nursing assessment is a clinical practice performed by registered nurses to deliver care to patients. Apart from the nursing practices, the registered nurses include the social determinants in order to create a proper nursing plan prioritizing the care user’s preference. The nursing plan created as a part of the nursing assessment helps to implement the information gathered in order to meet the care user requirements.
Ischemic stroke occurs due to blockage of any artery to brain and thus, brain receives less oxygenated blood and cannot perform its functions properly. As per the view of Schönenberger et al. (2016), the human brain depends on the arteries to bring fresh blood from heart and lungs. Therefore, in case of ischemic stroke, the blood vessels became narrower due to some blockage. Most common ischemic stroke is thrombotic stroke and the arteries carried out blood to brain become blocked. Therefore, the cells of brain died or became more damaged. As per the case scenario, it has been identified that Mr. Bright is feeling pain after having his angioplasty. Therefore, medical practitioners have assumed that he might have face ischemic stroke that can increase her life risk.
It has been often been evidenced that Mr. Bright has often faced sudden weakness or numbnace of leg on left side. Moreover, he is not being able to speak properly and understand other’s instruction. As he is not feeling enough strength to his left leg, therefore, he might have been facing difficulties during his walk. He also lost his balance and unable to coordinate during his walk (Goyal et al. 2016). He has also faced dizziness and sudden headache, with no known causes. After identifying these symptoms, his medical supervisor assumes that Mr. Bright might have facing Ischemic stroke. Due to this, a blood cottage might have developed in the brain arteries and thus, brain cells receive less originated blood. Therefore, brain cannot perform its normal function.
In order to provide proper treatment to people, who are having Ischemic stroke, need to be regularly monitored. As Mr. Bright has suspected to have Ischemic stroke, therefore, he need to be regularly monitored and care providers are required to list down every single detail about him. Therefore, it helps doctors to give appropriate therapy and medications by considering his physical symptoms. In addition to this, care providers are also required to give systematic approach to identify the area of discomfort. Intravenous injections of tissue plasminogen activator (tPA) can also be very effective in order to minimize the effect of ischemic stroke as well (Fransen et al. 2016). Furthermore, care providers need to practice verbal and non-verbal interaction as much as they can to understand physical discomforts of Mr. Bright.
In order to elect a stimulatory response to Mr. Bright, the correct nursing assessment was Physical assessment:
When Mr. Bright complained about the physical discomfort the registered nurse had undergone a physical assessment that included:-
Communicating with Mr. Bright and his family to record the exact cause:-
The vital signs were monitored noting the following parameters:-
Mr. Bright had undergone an angioplasty very recently and thus, it was necessary to record the minutes to monitor the proper functioning of the heart and heart rate pattern was also recorded simultaneously.
Along with this few more parameters such as blood pressure, oxygen saturation and pain were recorded as the fluctuations report which seemed to be a vital condition of the heart.
In the case of Mr. Bright intravenous thrombolysis accompanied by tissue, type plasminogen was recommended as per the stroke guidelines the beneficial effects of this intravenous treatment are more time dependent. In the case of intracerebral hemorrhage, the use of tPA is limited to a certain extent (safetyandquality.gov.au 2018). A detailed medical history from the patient family should be collected in order to avoid any complications (Triccas et al. 2018).
|
Introduction |
Name: Lisa Gomes Designation: Registered Nurse Ward: adult patient cardiac care
Patient name: Mr. Bright Age: 80 Sex: M Admitting Doctor: Smith Carol |
|
Situation |
Mr. Bright had undergone angioplasty last week and after he was discharged he is experiencing pain on the left portion of his chest. The physical symptoms observed in the patient seem an alarming concern for the healthcare professionals. Furthermore, it has also been identified that he was facing difficulties while walking on floor and unable to maintain body balance. Furthermore, he often felt dizziness and sudden headache without any known cause. He also felt weakness and numbness on his left leg and felt difficulties while speaking to other persons. |
|
Background |
Mr. Bright is 82 years Male patient who had undergone a recent angioplasty and reporting to face adverse effect from the prescribed medicines. However, he was discharged within a day of angioplasty and no neurological examination was performed before performing angioplasty and post treatment. In addition to this, it has also been found that, symptoms of his physical dis-comfortness were also not identified primarily. |
|
Assessment |
Mr. Bright is experiencing severe prolonged pain for the last few hours along with this sweating to a large extent. Patient is feeling difficulty in communicating with nurses probably due to difficulty in inhaling for ischemic stroke symptoms. In addition to this, it has also been discovered that he was not getting enough strength on his left leg and thus unable to move and make body balance while walking. |
|
Recommendation |
As per the documents provided patient has already mild stroke a few months before and the family history reflects heart disease to be a hereditary factor running for generations. His difficulty in uttering and sweating gives a vital symptom for stroke. Therefore he should be admitted to the emergency ward for clinician examination and effective treatment. He might require a pacemaker. Furthermore, he also needs to give Intravenous injection of tissue plasminogen activator (tPA). Therefore, it can help to remove the clot, present in blood vessels. Thus, it also helps to send more oxiginated blood to his brain cells and improves his health condition.
|
Nursing practice is always preceded by the nursing assessment that depends on the guidelines laid by National Safety and Quality Health safety standards. The nursing assessment is to access all the social determinants of health, family, financial status food security and so on to understand present health status. When a care user undergoes a critical treatment or surgery it is very important to take utmost care for the patient failing of which might result in adverse effects.
