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CNA 155 Clinical Reasoning Report

Added on - 23 Feb 2020

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Running head: NURSING CASE STUDYNursing Case StudyName of the student:Name of the university:Author note:
Running head: NURSING CASE STUDYThis case study is about Mrs. Amari who is a fifty-nine (59) year old New Zealand Maoriwoman. She was born in Auckland, New Zealand and lived in New Zealand until 3 years ago.After the loss of her husband, she struggled financially and moved to Australia to live with herson. She has been suffering from hypertension and hypercholesterolemia. She has been takingtobacco since 25 years and quit it ten years ago. She has a positive family history of heartdisease. She does not follow proper exercise regimen but, occasionally takes walks in theneighbourhood. Her son Niko married an Australian girl, and moved to Australia 6 yrs ago.Together they have two daughters and Mrs. Amari enjoys helping out withher grandchildren andplays an important role in taking care of them as both are working parents.One day Niko noticed that all of a sudden his mother was slurring in her speech and herface was drooping on one side. Mrs. Amari told her son that she was feeling some numbness onthe right side of her face and in her right arm. Niko got scared that his mother was having astroke so he brought her to the hospital.She did not experience any significant weakness, had asteady gait, and was able to swallow food without any difficulty. She was able to move all of herextremities and follow commands in a proper manner. Her pupils were round, equal and reactiveto light (4mm to 2mm). There was no nystagmus noted. Mrs. Amari did not have a headache andthere were no symptoms of nausea, vomiting, chest pain, diaphoresis, or visual complaints.Her current medical test report showed that her body temperature was normal that is36.7°C, blood pressure was 148/97 that showed that she had a high systolic pressure. Sherecorded a higher pulse of 81 and the reported respiratory rate was 14 that is in the normal range.The Oxygen saturation level (SpO2) was also in the normal range of 94%. Mrs. Amari’sGlasgow Coma Scale (GCS) was in the normal range of 15. She had a normal blood glucoselevel of 6.6mmol/L .A head computed tomography (CT) scan showed no acute intracranial
Running head: NURSING CASE STUDYchange and magnetic resonance imagery (MRI) was within normal limits. Mrs. Amari wastransferred from the emergency department to the stroke unit under the care of a neurologist witha diagnosis of a mini stroke that is a transient ischaemic attack (TIA).Mrs. Amari was on the stroke ward for 24hrs. Her symptoms were resolved. There wasno facial asymmetry and her complaint of numbness also subsided.But it was found that herclinical situation was changed. Her speech was slurred again and the right side of her mouthstarted drooping again. She was again examined for several parameters. Her body temperatureslightly increased to 36.8°C and the blood pressure rose to 175/105.This showed that she had ahigh systolic and a diastolic pressure as well. She recorded a higher pulse of 90 and the reportedrespiratory rate decrease to 13. The Oxygen saturation level (SpO2) also decreased to 92%. Mrs.Amari had a normal blood glucose level of 6.6mmol/L.According to her symptoms of slurring speech and the right side of the face droopingagain she is suffering from dysarthria which is a neurological disorder and leads to facialparalysis and muscle weakness of the throat (Solomon et al.2017). The reason of this disease inMrs. Amari is ischemic stroke, but there are other reasons as well such as tumor in the brainand cerebral palsy. Dysarthria leads to loneliness and depression in individuals. Mrs. Amarishould be given proper speech and language therapy that would help in improving her speechand communication with her family members. Speech therapy also plays an important role inimproving the strength of muscles and breathesupport (Miller and Bloch 2017).Nursing interventions and family support can also helpherin the prevention ofdiseaseand otherpsychological symptoms associated with it. It should be given to her in an efficientway which would help her to get rid from physical pain and stress. She should be given
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