Case Study on a Stroke Patient - Nursing Care and Decision Making

Running head: CASE STUDY ON A STROKE PATIENT
CASE STUDY ON A STROKE PATIENT
Name of Student
Name of University
Author Note

CASE STUDY ON A STROKE PATIENT1
The essay is based on a case study of an ischemic patient. Ischemic is defined as a heart
disease where there is reduction in a person’s blood supply in heart. Most of the ischemic heart
diseases is caused due to atherosclerosis and is usually present in the angiography the artery
lumen appears to be normal. In the initial days, there is sudden narrowing and sudden closure of
either huge coronary arteries or the coronary artery whose end branches are filled with debris
that is showering in downstream direction in the flowing blood. Ischemic heart disease is also
sometimes felt like angina, especially when the affected area is large (Béjot, Daubail and Giroud,
2016). It also sometimes leads to heart attack but is rare. The heart attack results in the
destruction in heart muscle by switching off its blood supply. Symptoms of this disease varies
from person to person even if the same type of ischemic disease detects them. However, the
problem lies when the person faces no symptoms and suddenly experiences heart attack or
cardiac arrest. In such cases, this disease is very dangerous and is complicated to treat as well.
Therefore, if a person suffers from a high blood pressure, it should treated cautiously and ECG
should be performed in order to detect the risk of the occurrence of ischemic heart disease.
Patients suffering from ischemic diseases more or less suffer from coronary heart disease as well.
In coronary heart disease, the coronary arteries are mainly affected which is responsible for
perfusion in the heart muscle. Coronary heart disease is a subtype of the cardiovascular diseases
like the ischemic heart disease (Sanchis-Gomar, Perez-Quilis, Leischik and Lucia, 2016). This
essay focuses on a particular ischemic patient named as Mrs. X. She had a transient ischemic
attack six months back and is detected to have atrial fibrillation, coronary heart disease,
hyperlipidemia and hypertension; though the hypertension is controlled now. Mrs. X had a left
knee replacement surgery three years back and was diagnosed with left arterial left ulcer. This
ulcer needs dressing three times a week. Mrs. X weighs 57kg. She takes diltiazem, atorvastatin

CASE STUDY ON A STROKE PATIENT2
and apixaben daily as prescribed by her doctor. Presently, she is having speaking difficulty and
drooping in the right side of her face. The case study also focusses on the recent respiratory and
heart rates and blood pressure of Mrs. X. Therefore, this essay focusses on the required medical
care for Mrs. X and relate it to the nursing practices.
Decision-making is defined as the process in making opinions about identifying a
decision and finding of relevant information as well as assessing alternative methods to solve the
problem (Yu,2013). Therefore, the process of decision-making comprises of seven main step. It
includes identification of the decision to be taken; assembling relevant information needed in
order to make the required decision; identification of alternatives if the taken decision proved to
be fatal; identification of a particular alternative from a lot in accordance with the evidence
found; lastly to take the action by implementing the alternative chosen. Lastly, the taken decision
is reviewed and its consequences are measured. This decision making practice plays an important
role in nursing profession. Nurses have to take prime clinical decisions in their regular practice
(LoBiondo-Wood and Haber, 2017). Nurses have to take decision in medical, surgical as well as
critical care units. It is termed as complexity of clinical decision making which requires wide
educational base and requires entry to reliable information sources and working in a supportive
environment. There are different nurses assigned to take decision and the junior nurses perform
(Jasper, Rosser and Mooney, 2013). This helps in an effective clinical practice by having a
positive impact on patient’s lives as well as in the global health care industry. Several models
have been proposed in order to evaluate the need of decision making in the nursing practice. All
this models proved to be very useful in the nursing practice. According to clinical settings,
nurses in everyday life have to face tough choices regarding decision- making. They have to take
many decisions regarding their patients’ wellbeing, how tough the decision is but they have to

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take it for their patients sake (Standing, 2017). Nurses also have to face ethical problems
regarding their decision making process. Some decisions they could have to take which will be
ethically cumbersome but for their patients’ sake or for their patients’ wish, they have to break
their ethical laws and take the decision. For example, if the patient undergoing a surgery does not
want to opt for another surgery ad it is painful for the individual to handle, then the nurses have
to face the ethical decision making problem where they have to go to against their wish and
support their patient. This is because for all nurses their patients are their first priority and it is
their prime duty to help their patient in recovery, how difficult it is. Nurses have to face
challenges in their day-to-day life and should have that communication skill and mental stability
in order to overcome from that challenging situation. Therefore, decision-making is an important
character in the healthcare industry, which helps the nurses to engage themselves with a
particular patient and in addition helps the patients to reflect their choice of preferences. In the
following case study, the patient named as Mrs. X who is a 73years old widow. She is an
independent woman who lives in a ground floor flat alone after demise of her husband few years
back. She does not have any children. One of her relative mostly visits her to check about her
well-being and to check whether there is any shopping requirement or not. Due to her bad
experiences in hospital, she refuses to be admitted to the hospital. She needs to be under all-time
nursing observation. This case study will help to know the role of nurses played in case of an
emergency stroke patient. Such patients need continuous nursing care. The nurses should know
the patient’s family history and in case of very high blood pressure, should constantly check their
patient’s blood pressure and heart care for future indications. These patients should take their
regular medication on time. Hence, the nurses should look into this matter as well. For ischemic