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In: Nursing

Jose Bretado is an 70 year old male w/no reported PMH. Went to bed last night...

Jose Bretado is an 70 year old male w/no reported PMH. Went to bed last night at 2000, when patient was last known normal. This morning, patient's roommate found him down with Left sided weakness at 0700 and called EMS. Upon their arrival, patient found to be tachycardiac to the 180s and given adenosine. Upon arrival to ED, patient found to be in afib. CT-A showed a Right MCA occlusion. Stroke Code activated and patient prepped for possible embolectomy.

Significant ED values- neuro checks showing left sided weakness, Rapid COVID test -, no significant lab values.

1. What imaging would you suggest?

2. Nursing considerations/ Dx?

3. Goals?

Solutions

Expert Solution

MCA , chronic middle cerebral artery occlusion as a cause of hemodynamic stroke has not been a prominent clinical issue in the western world. The most common cause of MCA occlusion is embolism, and sudden occlusion of the proximal MCA by an embolus is one of the most frequent causes of major stroke.

Symptoms are , deficits movement and sensation.

Difficulty to swallowing

Impaired speech ability.

Impaired vision and partial blindness

Headache

Hemineglect

CT scan three main stages are used to describe the CT manifestation of stroke.CT angiograms that identify occluded blood vessels .

Embolectomy mean surgical removal of an embolus.embolectomy catheter is a device developed in 1961 by Dr.thomas j.forgarty to remove fresh embolism in the arterial system. It consists of a hollow tube with an inflatable balloon attached to its tip. The catheter is inserted into the blood vessels through a clot.

This surgery generally takes one to four hours it may take several months to recover fully from the procedure, including healing of the sternum and regaining strength.

A catheter is inserted into the affected vessels and is used to remove the clot. Surgical embolectomy this involves traditional open heart surgery to remove the blood clot from the affected artery or vein. After dividing the breastbone your surgeon will open the affected blood vessel and remove the clot.

2.* Imbalnced nutrition less than body requirements related to inability to ingest or digest food or absorb nutrients, nausea, and vomiting,NPO status, and nasogastric suctioning.

*impaired bed mobility related to pain secoundary to musculoskeletal impairment.

* in effective peripheral tissue perfusion related to obstructed pulmonary artery.

* Risk for shock related to increased workload of the right ventricle.

* acute pain related to pleuritic origin.

3. * Increase perfusion

* verbalize understanding of condition, therapy regimen, and medication side effects.

* display hemodynamic stability.

* report pain is relieved or controlled.

* follow prescribed pharmacological regimen.

Nightingale answered 1 year ago
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