Question

Mr. Jackson is a 38-year-old African American that presents with an altered level of consciousness (ALOC). He has been having headaches for the last three months but due to a hectic work schedule he has not been able to go to see his medical practitioner. During his last visit two years ago, his blood pressure was slightly elevated, but he never followed up. Upon arrival to the ED a CT scan is completed and it shows a large bleed near the frontal lobe. What should Mr. Jackson's plan of care include?

Possible Medications (minimum of 2)

Clinical Manifestations Subjective: Objective:

Possible Nursing Diagnosis           (minimum of 2)

Medical Diagnosis STROKE- (Hemorrhagic)

Patient Data/Risk Factors

Medical Interventions

Pathophysiology

Nursing Interventions (minimum of 4)

Diagnostic Data

Patient Education (minimum of 2)

Answer 1

Possible medication

• Administer antihypertensive to reduce the elevated blood pressure
• Administer diuretics to ensure that it can decrease the intracranial pressure by eliminating any excessive fluid buildup in the brain.

Clinical manifestations

• Loss of consciousness
• Headache
• Dysphagia
• Weakness or paralysis on the opposite side of the affected brain
• Nausea and vomiting
• Dizziness

Subjective data

• Headache
• Hypertensive

Objective data

• ALOC
• Elevated blood pressure
• Hemorrhage in the near frontal lobe

Nursing diagnosis

• Ineffective cerebral tissue perfusion related to bleeding as evidenced by loss of consciousness, headache
• Ineffective cardiac tissue perfusion related to bleeding as evidenced by elevated blood pressure

Patient data/Risk factor

• Poor medication adherence for blood pressure control

Medical intervention

• Antihypertensive
• Diuretics
• Analgesics to reduce pain
• Antiepileptic drugs to prevent seizure episode.
• Diuretics to prevent cerebral edema

Pathophysiology

The elevated blood pressure leads to increased and forced blood supply to the brain cells which can lead to rupture of blood cells. As a result the neurological functions associated to that parts are lost .

Nursing interventions

• Monitor the patient's vitals to know the baseline status and plan for care
• Monitor the GCS every hourly
• Administer medication as per your eder
• Provide elevated head end to prevent edema, increases ICP levels

Diagnostic data

• CT scan, MRI Scan
• Angiogram to assess the exact site of bleeding and treat accordingly
• Clotting factors
• CBC to assess for any infection
• Serum electrolyte
• Lipd profile

Patient education

• Encourage to take medication as per order ,not to skip or under or overdose
• Ensure patient to have proper and redukar follow up to assess the statuas and prevent ant complications earlier.