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Case: Left-Sided Weakness M.R. is a 67-year-old African-American female who presents to the emergency department with...

Case: Left-Sided Weakness

M.R. is a 67-year-old African-American female who presents to the emergency department with left-sided weakness.

Subjective data:

  • PMH: HTN, hypothyroid, sickle cell anemia
  • Sudden onset of headache
  • Current smoker, 1 pack a day for 45 years
  • Having trouble speaking
  • Left-sided face droop
  • Reported pain 6/10

Objective data:

  • Height: 5'6"; weight: 192; BMI: 31
  • Vital signs: T 37 C, P 72, R 18, BP 174/94
  • Lungs: clear all bases
  • O2 sat: 100%
  • CV: heart rate regular, positive peripheral pulses

Medications: metoprolol 12.5 mg per day, Synthroid 0.50 mcg once per day

Cranial nerves: negative response from cranial nerves VII, IX, II-VI and VIII, X-XII intact

Questions

  1. What other questions should the nurse ask about the left-sided weakness?
  2. What other assessments are necessary for this patient?
  3. What are some of the causes of left-sided weakness?
  4. Develop a problem list from objective and subjective data.
  5. What should be included in the plan of care?
  6. What other risk factors are associated with this presentation?

Solutions

Expert Solution

1.Questions the nurse should ask

  • Time of onset of weakness
  • What was the patient doing at that time
  • Told that the onset was sudden explain how it happened
  • Was it for the first time incident like this
  • Patient told about headache any other problems in addition to head ache

2.Necessary assessments

In addition to the assessment like vital signs monitoring and cranial nerve assessment which have already done other assessments include

  • Complete physical examination
  • CT/MRI brain
  • Blood studies

3.causes of left sided weakness

  • Stroke
  • Brain /spinal cord injury
  • Infection to brain
  • Brain tumors
  • Multiple sclerosis

4.Problem list from subjective and objective data

  • Left sided weakness
  • Face droop
  • Head ache
  • Hypertension
  • Hypothyroidism
  • Sickle cell anaemia

5.Plan of care

The plan of care include

  • Assessment and final diagnosis
  • Stabilize the vital signs
  • Blood studies as needed
  • Care for basic needs of the patient
  • Start treatment based on diagnosis with out delay

6.Risk factors

  • Smoking
  • Hypertension
  • Age
  • Hypothyroidism

Nightingale answered 2 years ago
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