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Read the following case study and answer the questions. Mrs. Saunders is a 70-year-old retired secretary admitted to your unit from the emergency department with a diagnosis of stroke (cerebrovascular accident, or CVA). She has a history of hypertension and atherosclerosis, and she had a carotid endarterectomy 6 years ago. She is 40% over her ideal body weight and has a 20-pack-year smoking history. Her daughter says her mother has been having short episodes of confusion and memory loss for the past few weeks. This morning she found her mother slumped to the right in her recliner, unable to speak. 1. Explain the pathophysiology of a stroke. Which type of stroke is most likely the cause of Mrs. Saunders's symptoms? 2. Mrs. Saunders is flaccid on her right side. What is the term used to describe this? 3. Which hemisphere of Mrs. Saunders's brain is damaged? 4. List four risk factors for stroke evident in Mrs. Saunders's history. 5. Mrs. Saunders appears to understand when you speak to her but is unable to speak intelligibly. She says "plate" when she means shower and "broccoli" when she means gown. What is the term for this? 6. Neurologic checks are ordered every 2 hours for 4 hours and then every 4 hours for 4 days. When you
1. Explain the pathophysiology of a stroke. Which type of stroke is most likely the cause of Mrs. Saunders's symptoms? 2. Mrs. Saunders is flaccid on her right side. What is the term used to describe this? 3. Which hemisphere of Mrs. Saunders's brain is damaged? 4. List four risk factors for stroke evident in Mrs. Saunders's history. 5. Mrs. Saunders appears to understand when you speak to her but is unable to speak intelligibly. She says "plate" when she means shower and "broccoli" when she means gown. What is the term for this? 6. Neurologic checks are ordered every 2 hours for 4 hours and then every 4 hours for 4 days. When you enter her room and call her name, she opens her eyes. She is able to squeeze your hand with her left hand. However, she is only able to make incomprehensible sounds. What is her score on the Glasgow Coma Scale? 7. List at least three early symptoms of increasing intracranial pressure for which you will be vigilant. (You may want to refer back to Chapter 48.) 8. List two medications that the health care provider may order. Why might they be used?
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