Case Study: Vertebral Artery Occlusion in a Patient with Hypertension and Type II Diabetes

Running head: NURSING
NURSING
Name of the Student:
Name of the University:
Author Note:

1NURSING
Response to Part 1:
The provided case study deals with the patient Jason Bourne who is 56 years old and was
presented to the GP with the presenting complaints of dizziness and headaches. The case study
suggests that the patient has a medical history of hypertension and Type II Diabetes. The pain
score during patient presentment was reported to be 8/10. In addition to this, the patient
complained of double vision and reported to experience a spinning head sensation. The vital
signs on admission revealed temperature to be equivalent to 36.5ᵒ C, pulse rate to be equivalent
to 73 and regular and respiratory rate to be equivalent to 15 breaths per minute. The blood
pressure was reported to be 170/90 and the SpO2 was reported to be equivalent to be 94% on
room temperature. The chemical investigation suggested that the blood glucose level was
equivalent to 6.5 mmol/L. Pupil reaction was reported to be brisk as well as equal, round and
reactive to light. Pupil size was reported to be equivalent to 3mm left and right and the GSC
score was reported to be equivalent to 15. Severe weakness was reported within the left limbs
whereas the right limb was reported to be normal in terms of strength. The patient was placed
under my care with a diagnosis of vertebral artery occlusion.
Research studies mention that vertebral artery occlusion differs from one patient to
another on account of the location of ischemia and the underlying reason that causes occlusion
(Fang et al., 2018; Singer et al., 2015). In addition to this, it should also be noted that the
common clinical symptoms of vertebral artery occlusion include dizziness, vertigo, headache and
stiffness within the limbs (van Houwelingen et al., 2016; Rangaraju et al., 2016). In addition to
this other symptoms such as weakness, ataxia, altered mental status, hemiparesis as well as
diplopia are also common in patients suffering from the medical condition (Lylyk et al., 2019;
Teleb et al., 2017).

2NURSING
Research studies suggest that the vertebrobasilar arterial system comprises an aggregate
of the vertebral and the basilar arteries and is placed at the posterior region of the brain. The
network of arteries are responsible for the supply of blood, oxygen as well as nutrients to the
vital organs such as the cerebellum, occipital lobes as well as the brain stem (van der Hoeven et
al., 2016; Qureshi et al., 2019). The condition of atherosclerosis that is caused due to the
deposition of cholesterol and fatty acids leads to the narrowing down of the arteries which
interferes with the maintenance of smooth blood flow through the network of arteries (Yang et
al., 2018). This leads to poor blood supply within the vertebrobasilar system as well as the vital
organs which subsequently leads to occlusion or blockage. The evidence base in this regard
states that the condition is likely to impact patient who suffer from hypertension which can be
aligned to the case study of the patient. The strain exerted on the arteries due to hypertension
causes deposition of plaque which gives rise to the condition of atherosclerosis (Zang et al.,
2017). The narrowing down of the arteries due to deposition of fat increases the likelihood of
formation of a clot which results in lack of optimal supply of nutrition and oxygen to the
concerned muscle and as a result a stroke or paralysis can also occur (Zang et al., 2017).
Response to Part 3:
The two priority nursing diagnoses during the time of discharge for the patient would
include,
 Persisting weakness within the left limb
 Assisted mobility
The short term goals for the patient would include the following:
 Patient would be able to cope with pain

3NURSING
 Patient would be able to exhibit stable vital signs
The long-term goals for the patient would include the following:
 Patient would be able to manage blood glucose level
 Patient would be able to take care of medication management
 Patient would gain strength in left limb and would be able to walk independently
The five interventions for the devised short term and long term goal of the patient can be
explained as under:
Patient would be able to cope with pain: As has been reported in the case study, the patient
initially complained of intense pain which was effectively managed by the time of the discharge,
however, the left limb was reported to be devoid of strength and under recovered. This might
trigger pain which would be managed with the help of effective pain management medication
such as ibuprofen which are available over the counter and belong the drug category of NSAIDs.
The rationale for the recommendation of the medication can be explained as alleviating pain and
muscle stiffness which can help to promote patient comfort (Baik et al., 2019).
Patient would be able to exhibit stable vital signs: Patient would be monitored and kept under
observation for 24 hours before discharge planning. The recommended treatment would remain
uninterrupted and it would be expected that during the time of discharge the patient would be
able to exhibit stable vital signs. As suggested by Tateishi et al. (2016), maintenance of stable
vital signs before discharge exhibits the normal physiological and metabolic body functioning
which can be considered as a positive sign of recovery.