Mrs. London’s Case Study: Pathophysiology, Communication, and Nursing Care

Running head: MRS. LONDON’S CASE STUDY 1
Mrs. London’s Case Study
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Institutional Affiliation

MRS. LONDON’S CASE STUDY 2
1. Pathophysiology Overview:
Pathophysiology describes the biological and physical abnormalities taking place in a
patient’s body due to illness (Debette et al., 2015, p. 640). Previously, stroke was called
cerebrovascular accident or CVA. It is described as the abrupt cerebral circulation impairment in
one blood vessels or more that supply the brain. Stroke causes distractions and decreases in the
supply of oxygen, triggering severe damages or even necrosis in a patient’s brain tissues. A
patient who suffers from CVA might display one or more of such symptoms as numbness or
weakness, or face, leg or arm’s paralysis on both or either side of her body (Seners, Turc,
Oppenheim & Baron, 2015, p. 90).
1. Left ischaemic CVA 2
In Mrs. London’s scenario, she has suffered a left-sided ischaemic CVA (Schleiger,
Wong, Read, Coulthard & Finnigan, 2016, p. 2832). An ischemic CVA is a cerebrovascular
illness or condition triggered by blood flow deprivation to the brain area, usually due to
embolism, thrombosis or decreased pressure of blood. The Ischaemic CVA takes place due to the
blockade within the blood vessels that supply the brain with the blood with the underlying
disorder for a condition for such kind of barrier being the development of the fatty deposit then
line the walls of the vessel (Moretti, Ferrari & Villa, 2015, p. 27). The name given to this
condition is known as atherosclerosis. Such fatty deposits might trigger two kinds of blockades
including cerebral embolism or cerebral thrombosis. The latter describes the blood clot
developing at a clogged portion of the vessel. The former obstruction describes the blood clot
forming at a different destination in the circulatory system, often the neck and upper chest’s large
arteries and the heart (Thomsen et al., 2017, p. 97). A part of such blood clot will break loose
and gets into the patient’s blood stream. It will then travel via the blood vessels of the brain until

MRS. LONDON’S CASE STUDY 3
it hits the blood vessels extremely little to let the clot go through. As a consequence of suffering
ischaemic CVA, Mrs.
2. Her expressive dysphasia
It describes impaired production of language triggered by certain kind of brain
dysfunction or damage. Simply put, expressive dysphasia is a partial language loss, often
following cerebral infarcts, a CVA, or TBI (traumatic brain injury). The profound feature of
expressive dysphasia is the speech disturbance or non-fluent output. It is marred with scattered,
dawdling, as well as hesitant speech with articulation, grammatical and rhythmic disturbances. A
patient further presents difficulties in choosing or finding correct words. It leads to reading
impairment alongside a jerky and halting flow; writing disturbances are identical to speaking
disturbances.
3. Her right-sided hemiparesis
This entails injury to left-side of the patient’s brain. The person’s brain left-side controls
language and speaking. Patients with this kind of hemiparesis can further experience difficulties
with communicating (talking and understanding) what other people are saying, and also
distinguishing left from right. London has right-sided hemiparesis of her leg and arm.
Hemiparesis describes a muscular weakness of 50% of the patient’s body (Debette et al., 2015, p.
650). As Mrs. London had the left-sided ischaemic CVA, her right-side of the body has also been
affected.
4. Her severe arm and leg weakness
The severe leg and arm weakness is caused by muscles weakness. It is always for entire
side of a patient’s body to get weak following a stroke, but one might experience weakness only
in one leg or arm. Weaknesses in muscles affect how a person can move her body. Occasionally,

MRS. LONDON’S CASE STUDY 4
it might get severe and halt a person from moving body parts, paralysis. Movement is also
affected by drop foot whereby a patient’s toes catch on ground as she steps forward due to
muscle weakness to lift the toes. CVA will trigger muscle weakness down a person side known
hemiparesis which leads to spasticity affecting the weakened muscles, usually in hands and arms,
but can affect legs. If spasticity is never treated, it might result in permanent muscle-shortening.
This will make muscles and joints to get stiff making it infeasible to move them leading to a
contracture.
It is feasible to indicate that the ischaemic CVA has occurred in either internal carotid
artery or middle cerebral artery since ischaemic CVA in such brain areas yields specific
symptoms displayed by Mrs. London. Modifiable risk-factors exist which an individual can
control to decrease her chances of stroke including HBP (hypertension), diabetes mellitus,
smoking, excessing plasma lipids (hyperlipidemia), sickle cell illness, physical inactivity,
obesity, drug or alcohol abuse and use of contraceptives (Li, Zhu, Chen, Hu, Wang, Li & Li,
2017, p. 108).
2. Communication
The expressive dysphasia influences Mrs. London's living communicating activity that
she is witnessing. This calls for the implementation of some nursing actions alongside care to
make sure that she can communicate as well as fathom communication (Bramhall, 2014, p. 59).
The nurse can use a written, oral, face-to-face, electronic, verbal as well as non-verbal
communication. Such communication will encompass the expression of oneself, hearing, feeling,
seeing, fathoming and subsequently expressing back to the person she is talking to (Bramhall,
2014, p. 57). For Mrs. London to effectively communicate, her assigned nurse need to undertake
various actions including: