Patient Situation : Clinical Reasoning Report – Nursing Assignment Clinical Reasoning Report A…

Patient Situation : Clinical Reasoning Report – Nursing Assignment

Clinical Reasoning Report

A fifty-eight (58) year old New Zealand Maori woman brought to the emergency department by her son,as he noticed that all of a sudden his mother “was slurring her speech and her face was drooping on one side.” Mrs. Hodge told her son that she felt some numbness on the right side of her face and in her right arm. Patient has a history of hypertension and hypercholesterolemia . She has a history of tobacco use for 25 years; quit ten years ago. She has a positive family history of heart disease. Occasionally she takes walks in the neighbourhood, but does not have a regular exercise regimen. Widowed, currently lives in Australia with son and his family help with looking after their
children. Mrs. Hodge did not have a headache and denied any nausea, vomiting, chest pain, diaphoresis, or visual complaints. Mrs. Hodge was alert and oriented. Her speech was slightly slurred but she could be understood. She was not experiencing any significant weakness, had a steady gait, and was able to swallow without difficulty. She was able to move all of her extremities and follow commands. Her pupils were round, equal and reactive to light (4mm to 2mm). There was no nystagmus noted.

You recognise that her clinical situation has changed. From this point, you need to determine what assessments you would do. You need to describe what cues you will gather and explain how the assessment techniques you choose are appropriate for Mrs Hodge at this time. This will form part of the ‘collect cues and relevant information’ section of your clinical reasoning report

1. Consider the patient situation
2. Collect cues and information
3. Collect cues and information(Interpret ,discriminate, relate and Infer) Guiding questions
4. What causes a TIA and what is the natural progression of a TIA?
5. Explain how a TIA differs from a cerebrovascular accident (stroke, brain attack, CVA)
6. Discuss the defining signs and symptoms of a transient ischemic attack (TIA).
7. Mrs. Hodge has hypertension and hypercholesterolemia. Think about why this is a concern.
8. Identify Mrs. Hodge’s predisposing risk factors for a TIA and possible stroke.(explain what is significant about patient’s age, culture, social history, medical history, normal parameters, bio-scientific principles underlying in this case and making link to the present situation)
9. What neurological assessments can be carried out on a patient with a changed neurological health status?