Question Answered step-by-step Case Study – Ischemic, Thrombotic Stroke Mr. Gonzlez is a… Case Study – Ischemic, Thrombotic StrokeMr. González is a 70-year-old retired bus driver who suffered an ischemic, thrombotic stroke on November 26, 2020. He has been in the rehabilitation hospital for 6 weeks and is now being prepared for discharge to his home with his wife. Mr. González has physically responded well to rehabilitation. He has mild dysplasia but is able to communicate well, though it takes a while to process words and respond appropriately. He has hemiparesis of his right side but can walk short distances with a walker, though is sometimes a little unsteady on his feet, and requires minimal assistance to complete his own bathing and dressing. Mr. González has been suffering from constipation since his stroke and his appetite has decreased, but he is otherwise well.Mr. González, has a past medical history of type 2 diabetes but has been diagnosed with hypertension and hypercholesterolemia since admission. He has no past surgical history. Mr. González has no known allergies. On admission he was on Metformin 500mg PO BID but is now also going to be taking Plavix 75mg, PO daily; ASA 81 mg, PO daily; Bisoprolol 5mg, PO daily, Atorvastatin 10mg, PO daily and Senokot 2 tabs, PO daily. His latest labs are unremarkable except a fasting BS of 8.4. His vital signs are as follows; T-36.8; P-86; R-17; BP is 148/96; O2 sat-93% on room air; he denies any pain. His fall risk on the Hendrick II Fall Risk scale is currently 4. Mr. González’s abdomen is soft and non-distended with bowel sounds present in all four quadrants.Mr. and Mrs. González are both 70 years old and of Hispanic origin. The preferred language in the home is Spanish, although both Mr. and Mrs. González are comfortable speaking English. On discharge, Mrs. González will be his primary caregiver and though they have no children they have a very involved extended family. Since he has new medications, will need his blood pressure and blood glucose monitored frequently, requires assistance with his ADL’s, and has some safety concerns due to his hemiplegia, the nurse is conducting a number of teaching sessions with Mr. González and his wife prior to discharge. These have also included fall prevention and stroke prevention. According to Mrs. González, the extended family believes in treating those who are “ill” with special foods and spices. The rehabilitation nurse conducts a more detailed assessment of home remedies with Mrs. González and discusses the potential for harm from drug interactions. The nurse has noted that in the past week stressors have been interfering with the teaching sessions. Mr. González’s mood has become increasingly anxious, and he becomes easily frustrated. Mrs. González also seems anxious and concerned. She asks to speak to the nurse privately and confides that she is afraid of “making a mistake.” She states she “does not feel confident” about what she has learned and she is “worried” about being able to assist her husband with his care. She is also frightened that he might have another stroke. The nurse spends time carefully reviewing the discharge instructions and reassures her that a home care nurse will be visiting for the first few weeks to follow up on Mr. González’s care. She tells Mrs. González that she will call the home care nurse and provide an update of Mr. González’s status and inform the home care nurse of Mrs. González’s concerns.PNC121_2197_2204Part #2 Nursing Diagnosis/Problem, Goal, Interventions, Evaluation (10%)The assignment includes completion of:1: One Nursing Diagnosis/ProblemSelect a priority problem from the problem area identified in part 1, and write one nursing diagnosis/problem statement.List the signs and symptoms that support your choice of priority problem.2. One short term SMART Goal/expected OutcomeWrite one SMART nursing goal/expected outcome for the nursing problem. This is a measurable statement of accomplishment that may be related to physical health or areas that need improvement for your client.3. Four Nursing Interventions with cited rationaleWrite a minimum of 4 appropriate interventions The interventions are nursing actions (treatments, behaviours, activities and therapies) that nurses perform independently on behalf of clients or in collaboration with other health care professionals. These are individual steps to help achieve the client outcome (goal).Provide ‘evidence based’ rationale to support and validate each intervention chosen. Use APA format for all evidence-based rationale supporting the chosen intervention. 4. EvaluationReflect on the effectiveness of interventions and the client’s progress to achieve the outcome. Do you believe the interventions would be effective in achieving the client outcome? Because you cannot truly evaluate the outcome it will be important to provide an explanation about what, When and how would you evaluate the nursing interventions? Health Science Science Nursing PH 133 Share QuestionEmailCopy link Comments (0)

Question Answered step-by-step Case Study – Ischemic, Thrombotic Stroke Mr. Gonzlez is a… Case Study – Ischemic, Thrombotic StrokeMr. González is a 70-year-old retired bus driver who suffered an ischemic, thrombotic stroke on November 26, 2020. He has been in the rehabilitation hospital for 6 weeks and is now being prepared for discharge to his home with his wife. Mr. González has physically responded well to rehabilitation. He has mild dysplasia but is able to communicate well, though it takes a while to process words and respond appropriately. He has hemiparesis of his right side but can walk short distances with a walker, though is sometimes a little unsteady on his feet, and requires minimal assistance to complete his own bathing and dressing. Mr. González has been suffering from constipation since his stroke and his appetite has decreased, but he is otherwise well.Mr. González, has a past medical history of type 2 diabetes but has been diagnosed with hypertension and hypercholesterolemia since admission. He has no past surgical history. Mr. González has no known allergies. On admission he was on Metformin 500mg PO BID but is now also going to be taking Plavix 75mg, PO daily; ASA 81 mg, PO daily; Bisoprolol 5mg, PO daily, Atorvastatin 10mg, PO daily and Senokot 2 tabs, PO daily. His latest labs are unremarkable except a fasting BS of 8.4. His vital signs are as follows; T-36.8; P-86; R-17; BP is 148/96; O2 sat-93% on room air; he denies any pain. His fall risk on the Hendrick II Fall Risk scale is currently 4. Mr. González’s abdomen is soft and non-distended with bowel sounds present in all four quadrants.Mr. and Mrs. González are both 70 years old and of Hispanic origin. The preferred language in the home is Spanish, although both Mr. and Mrs. González are comfortable speaking English. On discharge, Mrs. González will be his primary caregiver and though they have no children they have a very involved extended family. Since he has new medications, will need his blood pressure and blood glucose monitored frequently, requires assistance with his ADL’s, and has some safety concerns due to his hemiplegia, the nurse is conducting a number of teaching sessions with Mr. González and his wife prior to discharge. These have also included fall prevention and stroke prevention. According to Mrs. González, the extended family believes in treating those who are “ill” with special foods and spices. The rehabilitation nurse conducts a more detailed assessment of home remedies with Mrs. González and discusses the potential for harm from drug interactions. The nurse has noted that in the past week stressors have been interfering with the teaching sessions. Mr. González’s mood has become increasingly anxious, and he becomes easily frustrated. Mrs. González also seems anxious and concerned. She asks to speak to the nurse privately and confides that she is afraid of “making a mistake.” She states she “does not feel confident” about what she has learned and she is “worried” about being able to assist her husband with his care. She is also frightened that he might have another stroke. The nurse spends time carefully reviewing the discharge instructions and reassures her that a home care nurse will be visiting for the first few weeks to follow up on Mr. González’s care. She tells Mrs. González that she will call the home care nurse and provide an update of Mr. González’s status and inform the home care nurse of Mrs. González’s concerns.PNC121_2197_2204Part #2 Nursing Diagnosis/Problem, Goal, Interventions, Evaluation (10%)The assignment includes completion of:1: One Nursing Diagnosis/ProblemSelect a priority problem from the problem area identified in part 1, and write one nursing diagnosis/problem statement.List the signs and symptoms that support your choice of priority problem.2. One short term SMART Goal/expected OutcomeWrite one SMART nursing goal/expected outcome for the nursing problem. This is a measurable statement of accomplishment that may be related to physical health or areas that need improvement for your client.3. Four Nursing Interventions with cited rationaleWrite a minimum of 4 appropriate interventions The interventions are nursing actions (treatments, behaviours, activities and therapies) that nurses perform independently on behalf of clients or in collaboration with other health care professionals. These are individual steps to help achieve the client outcome (goal).Provide ‘evidence based’ rationale to support and validate each intervention chosen. Use APA format for all evidence-based rationale supporting the chosen intervention. 4. EvaluationReflect on the effectiveness of interventions and the client’s progress to achieve the outcome. Do you believe the interventions would be effective in achieving the client outcome? Because you cannot truly evaluate the outcome it will be important to provide an explanation about what, When and how would you evaluate the nursing interventions? Health Science Science Nursing PH 133 Share QuestionEmailCopy link Comments (0)