Nursing Case Study: Mr. Brown

Running head: NURSING CASE STUDY: MR. BROWN
NURSING CASE STUDY: MR. BROWN
Name of the Student:
Name of the University:
Author note:

1NURSING CASE STUDY: MR. BROWN
Question 1
From the assessment reports performed for Mr. Brown, the following assessment
procedures were correct as per his post-angioplasty risk of developing an ischemic stroke:
1. Pain Assessment: The risk of ischemic stroke is associated with a hematoma or a
thrombus blocking the blood vessels, resulting in disrupted circulation to surrounding
muscles, resulting in pain, which is a why a PQRST assessment is of utmost importance.
Hence, an adequate PQRST will involve a enquiring Mr. Brown using a patient, centered
approach, on how palliative or provoking his pain his pain is, the quality of his pain,
where does his pain radiate to, the severity of his pain and the timing of his pain. A
PQRST was performed adequately as observed from Mr. Brown’s description that his
pain radiated from his chest, arm and to the jaw (Raina, Krishnappa & Gupta, 2018).
2. Neurovascular Observation: A possible ischemic stroke post angioplasty, due to
disrupted circulation and hemorrhage resulting in hindered cerebral and neurovascular
functioning. A neurovascular observation as evident from the handover is performed
every 15 minutes and will involve nursing inspection of the reaction to towards light by
Mr. Brown’s pupil, the accommodation of the same, the presence of any form of
asymmetry in his face and a complete evaluation of his level of consciousness, such as
the presence of lethargy, coma, stupor and obtundation in Mr. Brown (Schreiber, 2016).
However, considering the condition of pain, risk of hematoma-induced ischemia in the
wound as well as history of diabetes, the following assessments should have been performed but
were not done so:

2NURSING CASE STUDY: MR. BROWN
1. Lower Limb and Wound Assessment: It has been mentioned that no form of lower
limb and wound assessment for the presence of any adenoma or bleeding surrounding
the puncture site. A major complication associated with angioplasty is the emergence of a
perfusion in the tissues resulting in an adenoma and hence the risk of an ishchemic
stroke. Hence, a lower limb assessment must be performed which will include the nurse
inspecting the wound are of Mr. Brown (Spillerova et al., 2015). This will involve
nursing inspection for any form of bleeding, oozing or exudates secretion from the
wound. The nurse must also inspect the wound site for the presence of any form of
hematoma which can be indicated by the presence of purple discoloration, redness,
swelling and increase of temperature. In the situation of any form of bleeding or
hematoma, the nurse then proceed to induce some form of compression using which may
encourage blood flow and stimulate homeostasis (Rahimi et al., 2016).
2. Vital Signs: A complete vital sign assessment was not performed in Mr. Brown. Hence
the nurse must be proceed to check Mr. Brown’s pulse, his rate of respiration,
temperature and rate of oxygen saturated in his blood. A vital signs assessment indicates
basic body functioning and hence abnormal finding is indicative of an emergency or
disease condition (Guy Jr et al., 2017).
3. Blood Glucose Assessment: There was no monitoring of the patient’s blood glucose
level despite knowing that the patient has a history of diabetes. Hence, Mr. Brown’s
blood glucose level must be evaluated immediately in order to monitor his diabetic status,
since metabolic complications are key facilitator in the development of an ischemic
stroke (Lau et al., 2018).