Question

Sensory-Neurologic System Case Study

You are caring for a 67-year-old female patient who was admitted to the hospital for headache and vertigo. When you enter the patient’s room she is lying in her bed and appears to be sleeping. She does not respond when you address her by name and looks pale, her significant other is at the bedside.

Assessment Findings

Mental Status:                         No verbal response, flexes right arm to pain, no eye opening

Airway:                                        Open and clear

Breathing:                                  RR irregular at 14

Circulation:                                 Skin normal color and dry, Radial pule slightly irregular at 32, BP 160/80

Other Findings:                        Temperature 37 C, pulse oximetry 97%, left pupil unreactive

History

Events:                                        The patient was admitted to hospital after complaining of a headache for the

                                                      last several days. Her husband states that earlier today she vomited several

                                                      times and got so dizzy she just couldn’t walk or even sit up in bed.

Previous Illness:                        Hypertension

Medications:                             hydrochlorothiazide

1. What is the patient’s Glasgow Coma Score? (include the total score and the individual scores for each area)

2. What is the relationship between posturing and a history of headache with hypertension?

3. Is there a relationship between the irregular respirations, bradycardia, and BP?

Answer 1

1. Glasgow comma scale is the assessment tool used to find the intensity of alertness and consciousness for the patient. It is the neurological assessment tool developed in 1974. Following the Glasgow score scale, the verbal responses are none so it will be scored as (1), eye opening is none so it will be scored as (1), right arm flex on pain is seen that is scored as (5). Total score is (7). The interpretation of this score explains that in range of score 3 to 8 the severity of the mental issue or neurological deficit is very high.

2. Posture is the individual's way to sit or stand or aligning with the balance of gravity, there is a close relation between posturing and headache and hypertension. Postural hypertension is a common element seen in some individual where change in posture indicates the change in blood pressure and as a symptom headache is perceived. This condition is common in neurological and spine related issues.

3. Bradycardia is defined as slow heart rate and it is seen to be closely associated with the irregular respiration and blood pressure. It is seen that the increase in blood pressure may cause bradycardia as the heart finds it difficult to pump blood and the cardiac output decreases causes low heart rate.

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