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

What other questions should the nurse ask about the left-sided weakness?
What other assessments are necessary for this patient?
What are some of the causes of left-sided weakness?
Develop a problem list from objective and subjective data.
What should be included in the plan of care?
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 1 year ago

Next > < Previous

Related Solutions

MC is a 52-year old African American female who presents to the emergency department with reports...

MC is a 52-year old African American female who presents to the emergency department with reports of shortness of breath, productive cough, and pain to her chest. She reports her cough is worse at night with chronic pain due to coughing. She denies wearing home oxygen and can been seen purse lip breathing. The nurse observed dyspnea on exertion when MC ambulated to the restroom. She states that she must stop halfway up the stairs in her home to catch...

Case Study W.A. is a 70-year-old African American female who presented to the emergency department with...

Case Study W.A. is a 70-year-old African American female who presented to the emergency department with fever, severe nausea, vomiting, and diarrhea. She is admitted to the intensive care unit (ICU) with a diagnosis of kidney failure and septicemia. Her previous medical history includes glaucoma, chronic kidney failure, hypertension, and insulin-dependent diabetes mellitus. She had a left above-the-knee amputation 1 year ago. Subjective Data A.’s daughter states she was able to do her daily chores at home independently, but for...

A 52 year old African American female presents to your clinic. She is complaining of weakness,...

A 52 year old African American female presents to your clinic. She is complaining of weakness, numbness and tingling in her feet as well as an itchy rash to her groin area. She states she was diagnosed with "sugar diabetes" (Type 2 diabetes) 6 years ago but she did not follow up with the recommendations for care from her previous provider. She states she doesn't like to go to the doctor because her dad had "a lot of health problems....

Jody Foster is a 28-year-old Caucasian woman who presents to the emergency department complaining of right-sided...

Jody Foster is a 28-year-old Caucasian woman who presents to the emergency department complaining of right-sided rib pain, neck pain, and headache after being physically assaulted by her husband. Last evening her husband came home intoxicated and became angry when their 12-month-old son began to cry. He punched her in the face, chest, then began to choke her by squeezing her neck for about a minute. She began to feel dizzy, but did not lose consciousness. She admits that this...

Jody Foster is a 28-year-old Caucasian woman who presents to the emergency department complaining of right-sided...

I. Assessment: AB, 65-year-old African American female, who was admitted for generalized weakness and pain in her...

I. Assessment: AB, 65-year-old African American female, who was admitted for generalized weakness and pain in her right foot. Vital Signs: T - 38.6 oral; P- 110 apical; R- 22; BP- 165/75 LUE, manual, sitting; Sp02 – 96% on RA. AB is awake, alert, and orientated x4. AB appears to be uncomfortable. AB denies any numbness or tingling. Her skin is appropriate for ethnicity and is warm to the touch. She is tachycardiac, rate of 110 and regular. Pedal pulses are...

A 67-year-old female patient presents to the emergency room you work at complaining of shortness of...

A 67-year-old female patient presents to the emergency room you work at complaining of shortness of breath and pain on the right side of her chest. Upon auscultation of the lung field during the physical exam, you note flatness and diminished breath sounds over the right lung. Her temperature is 101.3°F. What are the possible causes of her symptoms? (What is your differential diagnosis?) What tests might order to determine the specific cause of this patient’s symptoms? Why? This patient’s...

Case: Tuberculosis I.P. is a 50-year-old female who presents to the emergency room with productive cough...

Case: Tuberculosis I.P. is a 50-year-old female who presents to the emergency room with productive cough and fever. Sputum results are positive for tuberculosis. Subjective data Patient states cough started 10 days ago, getting worse Reports feeling tired and no appetite for days Smokes 1 pack a day for 33 years Married with two children, ages 12, 14 Takes a “sugar” pill to help with diabetes Works as home health aide Objective data Vital signs: T 38 C, P 64,...

67-year-old female presents with chief complaint of shortness of breath, fatigue, weakness, unintentional weight loss, and...

67-year-old female presents with chief complaint of shortness of breath, fatigue, weakness, unintentional weight loss, and mild numbness in her feet. She states she feels unsteady when she walks. PMH includes hypothyroidism well controlled on Synthroid 100 mcg/day. – Presents with pale conjunctiva of eyes and pale palate. Tongue beefy red and slightly swollen with loss of normal rugae. Turbinate’s pale but no swelling. Liver edge palpated two finger breadths below right costal margin. No hx of HTN or CHF....

Mr. T presents to the Emergency Department (ED) with right sided weakness, slurred speech, and bruising...

Mr. T presents to the Emergency Department (ED) with right sided weakness, slurred speech, and bruising on his right side from falling when he tried to get out of a chair. His wife states that he had experienced the same symptoms a month ago, but they resolved in a few hours so they did not think too much about it. You explain to the patient that what he experienced a month ago was a TIA. 1. Describe a transient ischemic...

Subjects