The patient was experiencing serious weakness of the right arm. In addition, the patient was not able to speak coherently. There was difficulty understanding what the patient was saying. The patient was also generally weak as the right side of body parts, including the leg, arm and eye, failed to be responsive (Donna & Linda, 2015). The patient lost body balance and coordination and complained of severe headaches. Despite being 78 years, the patient is also obese, an African American and has previously suffered from diabetes. As reported, the patient has a habit of cigarette smoking, and was once a chronic victim of alcohol drinking and drug abuse. All these are risk factors for heart failure.

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Medical Care
Upon the reception of the patient in the ER room, Trandate IV and Vasotec were administered but the conditions remained persistent. The patient was taken through various quick tests to determine the risk factors that are linked to stroke. Blood pressure tests were conducted and a stethoscope was used to listen to the patient’s heart and detect any whooshing sounds over carotid arteries of the neck in effort to determine the presence of atherosclerosis. A computerized tomography (CT) scan was conducted with the help two X-rays to examine the patient’s brain. A dye was also injected into the patient’s bloodstream to determine the blood vessels in the neck and brain regions (Donna & Linda, 2015).

From these tests, it was determined that the patient had a blocking in the artery indicating the presence of an ischemic stroke. Thus, as an emergency intervention, there was need to promptly restore blood flow to the patient’s brain. The patient was immediately given aspirin that prevents the formation of blood clots. This was done to minimize the chances of having another stroke. Tissue plasminogen activator (tPA) was also administered to minimize the long-term effects of linked to stroke. This medication plays a role of dissolving the blood clot so as to improve the flow of blood in the right part of the brain affected by the stroke. This medical intervention has been proved to have the ability to reduce disability associated with stroke by up to 30%.

Nursing Care
To prevent secondary brain injury and provide general body support that fosters quick recovery, nursing care is critical to stroke patients. The patient was positioned in a way that prevents contractures and relieves pressure. Proper positioning ensures that the patient attains a good body alignment (Pellico, 2013). Adduction of the affected arm was also prevented by placing a pillow in the axilla of the patient. Moreover, there was need to prevent fibrosis and edema by elevating the affected arm. On a daily basis, caregivers were advised to provide the patient with a full range of motion five times so that joint mobility is maintained (Theofanidis & Gibbon, 2016). Caregivers would also help the patient in regaining body balance. Personal hygiene is also another significant nursing care. The patient will be encouraged to observe personal hygiene activities immediately sitting balance is regained. The services of a speech therapist will also be sought to assist the patient in using alternate swallowing techniques (Donna & Linda, 2015). While carrying out these nursing interventions, written schedule and routines or checklists that are consistent with the patient’s activities will be developed. The skin will frequently be assessed for detection of any signs of breakdown so that speedy interventions are developed (Theofanidis & Gibbon, 2016; Pellico, 2013).

Nursing Problem
There are various nursing problems related to handling of stroke-related deficits. First, providing nursing care is stressful and caregivers go through individual challenges linked to insufficient knowledge and skills to deal effectively with cognitive, behavioral, emotional and physical challenges experienced by stroke patients and survivors. Second, there are diverse interpersonal issues relating to changes in relationships between stroke patients and their caregivers (Pellico, 2013). The conditions causes imbalances in social roles and relations. Third, there is a problem linked to organizational issues in the sense that it is difficult to identify and use community services and resources when dealing with stroke survivors. Lastly, given the financial implications of treating stroke, most nursing interventions fail to yield expected outcomes. Some of the patients may not be responsive to nursing interventions being utilized and may require expensive specialized treatment (Theofanidis & Gibbon, 2016).

    References
  • Donna, D. I, & Linda, M. W. (2015). Medical -Surgical Nursing: patient-centered collaborative care, single Volume, (8th Edition). Saunders Publishers.
  • Theofanidis, D., & Gibbon, B. (2016). Nursing interventions in stroke care delivery: An evidence-based clinical review. Journal of Vascular Nursing, 34(4), 144-151.
  • Pellico, L. H. (2013). Focus on adult health. Wolters Kluwer Health/Lippincott Williams & Wilkins.