CARE PLAN/CASE STUDY
Student’s Name:
Contact Dates: 11/07/2013
Client’s Initials: FL Room Number: 439 Age: 68 Race: African American Sex: M
Date of Admission: 1/18/2013 Allergies: No known Allergies
Primary Diagnosis
CVA (Ischemic Stroke): Deficient blood flow to the brain from a partial or complete occlusion of an artery. Ischemic strokes are divided into thrombotic and embolic and account for about 80% of all strokes (National Institute of Neurological Disorders and Strokes, n.d.).
Text Client Predisposing 1. Atherosclerosis 3, 4, 8, 9, 11 factors or 2. Heart disease causes 3. HTN
4. Smoking
5. Kidney disease
6. Peripheral vascular …show more content…
While in the ICU, the patient remained stable hemodynamically. Over the next couple of days, patient’s left side weakness worsen somewhat and at the time of discharge, his left-sided strength is 1/5 in the upper extremity and 1/5 on the lower extremity. MRI of the brain showed acute ischemic stroke, involving the right posterior temporal, right frontal supramarginal gyrus, posterior third right cortex and right parietal subcortical white matter. Carotid Doppler scan did not show any stenosis. Echocardiogram was normal with no thrombus and normal right ventricle. The patient was started on aspirin 81 mg q daily and statin and his blood pressure was controlled with hydrocholothiazide 12.5 mg daily. For his seizure disorder, the patient remained seizure-free throughout the hospital course and he was continued on Keppra 1500 mg b.i.d and carbamazepine 350 mg b.i.d.
During the hospitalization course, the patient developed acute respiratory failure due to upper airway swelling and had stridor and patient was intubated. Over the next day and a half, the patient remained stable while on the vent and for his upper airway swelling he got racemic mixture and steroid to which he responded well and extubated. Postextubation the patient was doing well on room air, without any desaturation or respiratory distress. Also during the course of the hospitalization, the patient had PEG placement and he has been tolerating his PEG feeds