In: Nursing
R.K. is a 72-year-old white man who was admitted with a massive stroke after collapsing on the street. He is unresponsive, even to painful stimuli. He has an oral endotracheal (ET) tube in place and is receiving mechanical ventilation (assist-control mode, FIO2 70%, VT 700mL, respiratory rate 16 breaths/min, PEEP 5 cm H2O). His chest x-ray revealed right lower lung consolidation. A subclavian central line was placed to monitor CVP and administer fluids. IV antibiotics have been started. His cardiac rhythm on admission was atrial fibrillation with a rapid ventricular response. He is receiving IV diltiazem (Cardizem) and his ventricular response has slowed to 84 bpm. His temperature is elevated despite receiving enteral feeding at 25mL/hr via small-bore nasogastric feeding tube and has an external condom catheter for urinary drainage.
Since stroke is the disease, how to make a stroke concept map while relating the concept map to R.K.'s condition?
INTRODUCTION
A stroke occurs when the blood supply to part of your brain is interrupted ,preventing brain tissue from getting oxygen and nutrients.stroke is a medical emergency and the treatment is very crucial,brain cells begin to die in minutes and eary medication can reduce the brain damage and other complications.
DEFINITION OF STROKE
The sudden death of brain cells due to lack of oxygen,caused by blockage of blood flow or rupture of an artery to the brain.
TYPES
* Ischemic stroke
* Hemorrhagic stroke
* Transient ischemic attack
ETIOLOGY
*Blocked or narrowed blood vessels are caused by fatty deposits that fits on blood vesels and go through blood stream and deposits in the blood vessels in the brain
RISK FACTORS
*Age
*Race
*Sex
*Obesity
*Heavy drinking
*Over use of illegal drugs
*Physical inactive
MEDICAL RISK FACTORS
*Diabetes
*High cholesterol
*Heart failure
*Personal or family history
SIGNS AND SYMPTOMS
*High blood pressure
*Trauma
*Aneurysms
COMPLICATIONS
*Paralysis
*Difficulty in talking and swallowing
*Memmory loss
*Pain
*Behaviour changes
*Emotional problems
OBJECTIVES FOR STROKE CONCEPT MAP
* Compare the different types of stroke
*Differentiate the signs and symptoms of stroke
*Find various diagnostic tools used for diagnosis
*Demonstrate proper nursing interventions and implementions
*Prepare proper health education
NURSING DIAGNOSIS
*Acute pain
*Impaired tissue perfusion
*Risk for constipation
*Impaired mobility
*Risk for heamorrage
NURSING INTERVENTIONS
*Monitor input and output
*Bp monitoring hourly
*IV infusion to chest pain and trauma
*Monitor PTT,platlet count
*Check the ET tube
*Give nasal feeding
PREVENTIONS
*Control high bp
*Control the amount of cholesterol
*Stop smoking
*Maintaing healthy weight
*Exercise regularly
*Take nutrious and blance diet
*Treat obstructive sleep apnea
*Avoiding overteke of drugs
*Moderate alcohol intake
MEDICATIONS
Anticoagulants
eg .rivaroxaban
Anti platelet drugs
eg .clopidogrel
CONCLUSION
Based on the above mentioning details,stroke is an emergency condition so that patient need special attention and hourly monitoring of bp and fluid intake and give good health education regarding risk factors to the family members because the patient is unconcious,after the relief of unconcious give speech therapy and physiotherapy and give diversional therapy.
BIBLIOGRAPHY
Brunner and suddarth medical surgical nursing
lewis's medical surgical nursing.
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