evidence based patient care

Nursing assessment performed on Mr. Bright relating to ischaemic stroke

Nursing assessment of Mr. Bright would begin with the consideration of the events as an ischaemic stroke in a prehospital phase and would continue in the entirety of the patient’s care. However, to conduct successful assessment and examination of the patient (Mr. Bright) ambulance member staffs and emergency medical technicians need to have extensive training to be able to recognize the symptoms and signs of the stroke condition.

Also, before treatment can be administered on the patient (Mr. Bright), it is essential to conduct a nursing assessment to determine the cause of the stroke. Studies show that ischemic stroke is caused by atherosclerosis – a condition whereby plague or fatty deposits build up in the blood vessels of the body. When these fatty deposits collect in one spot of blood cells, they can prevent the free flow of blood to essential and sensitive organs of the body (Brennan, 2013). Further, a blockage can be created where blood clots are stuck to plagues while moving in the blood vessels. Carotid arteries are particular arteries that enhance the flow of the blood to the neck. However, if these arteries get blocked by fatty deposits, they can cause a stroke in a patient.

Therefore, there is a high possibility that Mr. bright is suffering from the following illness conditions, which are considered as the risk factors for stroke:

• Diabetes – studies show that individuals struggling with diabetes are five times more likely to suffer from an ischemic stroke.
• High blood pressure – is the primary cause of ischemic stroke.
• Carotid artery or atherosclerosis disease – family history of the disease condition
• Fibrillation atrial – 14 percent of embolic stroke occurs to an individual who is suffering atrial fibrillation
• Level of cholesterol in the body – this may include low ‘sufficient’ HDL or high ‘poor’ LDL cholesterol
• Being obese or overweight
• A prolonged period of inactivity – failing to engage in physical exercise can results to high blood pressure, becoming overweight, high cholesterol, which can make an individual have plagued, and fatty deposits build up in blood arteries.
• Being on unhealthful dietary – taking too many meals with trans or saturated fat, sodium, cholesterol, and sugar can give rise to building up of plagues, diabetes, high cholesterol, and high blood pressure.
• Aging – people who are over 55 years are at high risk of getting a stroke.

Having now established the cause and possible symptoms of the ischemic stroke, it is essential to consider how to administer therapy treatment to Mr. Bright (Brennan, 2013). It is important to recognize that the administration of therapy to the patient would depend on significant factors including his general physical and psychological health, age as well as the location and severity of the condition. Our primary assessment goal here would be to remove the blockage in his brain to ensure the free flow of blood.

Here are below are the therapies that would be administered on the patient.

Thrombolytic agent therapy – it is the administration of busting-clot medication that would help to dissolve the blood clots blocking the cerebral part of the brain vessel. This therapy would contribute to restoring flowing of blood in the brain. This therapy process is also referred to as plasminogen tissue activator. However, it is a risky process, and hence it is advisable to administer the therapy to the patient immediately after establishing symptoms of stroke.

Neuroprotective therapy – administration of particular medication would help to minimize the damages resulted from the death of the brain cells associating with the stroke.

Maintenance and preventative medications

Antiplatelets/anticoagulants – the patient (Mr. Bright) would be prescribed antiplatelets (warfarin) and anticoagulants (aspirin). Administration of this medication would help to prevent clotting of blood in the blood vessels. Also, the patient would also be required to take other prescribed medications to assist in relieving his pain, control seizure, increase the flow of blood and reduce the level of blood sugar and fever.