Case Scenario
Part A
Mrs. Barlow is a 77-year-old woman living in Melbourne. She was admitted to a medical ward via her GP’s surgery where she presented with a severe headache. In the Emergency Department, Mrs. Barlow, had a full blood screen, an ECG, commenced on cardiac monitoring and was sent for a CT scan. Her past history includes: Hypertension, obesity and diabetes. Mrs. Barlow lives alone in a flat, is active in her church and attends a seniors group once a week. She has two grown up children who live in Adelaide. Her medications include: nifedipine (CR) 60 mgs daily, furosemide 20 mgs daily and potassium chloride 8 mEq twice a day. Mrs. Barlow is on a low calorie and reduced sodium diet. She has been instructed by her GP to take a short walk twice a day, however, her knees get painful and she does not always comply with his advice. When you initially meet Mrs. Barlow you observe that while she appears to understand you, she is having difficulty following your conversation. You also observe that her responses to your questions are at times inappropriate. Her initial obs: T, 36.8, P 106, BP 174/98 mmHg, R 26, Oxygen sats. 96% on room air and BSL 16. She had been prescribed aspirin and was administered TPA (Tissue Plasma Accelerator) in the ED.
1. Explain the pathophysiology that occurs in ischaemic vs a haemorrhagic stroke. 350 words
2. Mrs. Barlow has been diagnosed with an ischaemic stroke. Taking into consideration her past history and current condition, identify potential complications, providing rationales from current literature. For three (3) of these complications, utilising current literature, discuss:
3. a) The nursing interventions required to prevent or minimise the risks of each complication identified. AND
4. b) How you would monitor Mrs. Barlow in the initial 24 hours of her admission. 1,100-1200 words
