Graduate Certificate in Nursing: Stroke Case Study Analysis

This case study analyzes the health challenges of Mr. Orkins, an 84-year-old stroke patient, highlighting issues such as high blood pressure, medication side effects, and physical symptoms like slurred speech and urinary incontinence. The study outlines necessary assessments, including vital sign monitoring and motor function evaluations, and proposes a comprehensive plan of care emphasizing antihypertensive administration and ongoing monitoring. Furthermore, the study emphasizes the importance of evaluating the effectiveness of interventions and monitoring patient progress to achieve optimal outcomes, including references to contemporary and relevant research. The case study follows the guidelines provided in the assignment brief, focusing on the clinical and management aspects of the patient's care and is intended to provide insights into stroke management, nursing interventions, and the development of patient care plans.

Stroke Case Study
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Introduction
Stroke is a deadly condition and requires constant monitoring such that an individual
does not develop complications. Basically, there is need to ensure that a close monitoring is
applied and other integrated approaches applied in the promotion of safe and secure lifestyle
(Rivkin et al., 2016, pp. 8-17). Most of the individuals fail to secure a good health status due to
the negligence of the medical staff and poor assessments which in the long run affect his safety
which is recommended. The following is a case study of Mr. Orkins, an 84-year old client who
requires constant monitoring to accomplish a good approach in the promotion of his health and
prevention of the complications. Basically, it is good to follow the best intervention in ensuring
that he is fine and that no complications arise which may cause a deterioration in the clinical
conditions or any factor which may exacerbate stroke (Goyal et al., 2015, pp. 1019-1030). The
following are some of the identified practices which must be put in place to reduce the
challenges and ensure that there is security:
Health challenges of Mr. Orkins
There are several things which Mr. Orkins presents with and there is a need to identify
with correct measures which should be put in place to reduce the adversity and ensure that a
good health status is accomplished. Comprehensively, there is a need to understand that the
healthcare interventions which are put in place for Mr. Orkins are not the best and requires
interventions which are focused on the achievement of the goals as well as other issues which
make the entire process a good approach (Powers et al., 2018, pp. 28-46). Based on the
assessments upon talking to Mr. Orkins, the following are some of the health challenges which
should be monitored for a good health status and reduction of the adversity of stroke as per the
normal guidelines and criteria:

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There is a problem with the blood pressure of Mr. Orkins and something needs to be done
in the control of the challenges and reduction of the adversity. Comprehensively, there is a need
to understand that normal blood pressure is good for a quality life but the client is suffering since
the approaches applied are supposed to be reduced in the promotion of a good health. Mr.,
Orkins has a blood pressure of 150/98mmHg which is abnormal and requires an immediate
intervention for a good control and reduction of the challenges. Basically, blood pressure
controls the body functions and it determines the heart rate which should always be within the
normal ranges (Kobayashi et al., 2018, pp. 425-433). A good approach in the promotion of
quality is necessary especially in the elimination of challenges and promotion of a quality health.
There are adverse consequences related to high blood pressure which should be identified and
controlled for elimination and prevention of the healthcare challenges.
Secondly, the drugs which Mr. Orkins is given are not satisfactory in the maintenance of
a good health especially in the control of the stroke condition. Stroke is a condition which result
in various changes in the body and nervous system requiring a range of medications which must
be used for a good approach and promotion of better health. Mr. Orkins is under medications
such as Diamicron, Amlodipine, and Simvastatin which majorly works for other
pharmacokinetic functions but basically does not ensure that there is a quality in the control of
the blood pressure and other major conditions which exacerbate the health status. There is a need
to follow a good guideline in the control of stroke and related symptoms through a wide array of
drugs and following a good health approach which is necessary in the elimination of challenges
as well as reduction of the various issues identified.
Loose urethral sphincters is a condition which raise an alarm for Mr. Orkins since the
room smells urine meaning he cannot control himself. The challenge could be caused by nervous

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complications which result in the loose muscles and lack of quality control mechanisms as
identified. Basically, there is a need to follow a good approach in the elimination of challenges
and promote quality and effective approaches in the successful recovery of the body (Menon et
al., 2015, pp. 1239-1244). Additionally, Mr. Orkins has slurred speech which is reduced and has
a challenge when it comes to the mode of speech identified, basically, the client requires a good
intervention which is focused at elimination of challenges and promotion of a good body which
can sustain basic functions and other functions which are important.
Assessments and interventions for Mr. Orkins
Since Mr. Orkins has stroke which is a condition caused by a number of challenges, there
are various assessments which should be conducted to ensure that the conditions are alright and
that the challenges are mitigated effectively. Comprehensively, there is a need to understand the
quality which is required in the control of blood pressure as well as the nervous system. Stroke
alters the body physiology and lead to challenges which are difficult to control as well as
eliminate. Basically, a good approach is recommended for the control of the challenges such as
blood pressure.
Monitoring of the vital sings is fundamental in the case of Mr. Orkins since there are
various alterations to the body physiology. Blood pressure, heart rate, respiratory rate and other
motor assessments are necessary frequently to monitor the health progress of the client.
Basically, there is a need to understand the quality which is recommended for success and other
issues identified in the control of the challenges. Based on the ideas presented, a good
assessment is recommended for control of stroke and related symptoms.
Plan of Care

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Administration of antihypertensive is the first care which must be prioritized for the case
of Mr. Orkins. Basically, the slurred speech, high blood pressure and other symptoms may result
in the permanent stroke which may cause death (Smithard 2016, pp. 287-294). Control of the
blood pressure is the first technique which can be used in the elimination of challenges and
promotion of success which is necessary.
Monitoring of the vital sings is another good approach which can be used in the
regulation of challenges and promotion of a good adventure in the control of the challenges.
Based on the approaches which are identified, it is recommended that policies are identified and
good approaches promoted for a successful accomplishment of the needs as recommended (Chen
et al., 2015, pp. 1980-1990). Better healthcare practices requires constant monitoring of the vital
signs for a good health an elimination of possible complications.
Evaluation and monitoring of progress
The evaluation process should follow a good approach in the comparison of the
symptoms of before and after interventions. Control of the adversity is a good approach which
ensures that better approaches are applied in the effective implementations as well as other
approaches necessary for a successful approach in the good healthcare (Abou-Chebl et al., 2015,
pp. 2142-2148). Also, monitoring the impact of the drugs administered and the management
approaches can serve a good purpose in the elimination of challenges and promotion of a good
technique which is necessary.
Conclusion
Management of a stroke patient requires keenness and quality adoption of techniques
which are focused at identification of challenges and promotion of better approaches as
recommended. Qualitatively, there is a need to understand the needs of better interventions and

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other issues which must be applied for successful accomplishment of a good healthcare outline
and quality approach.

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References
Abou-Chebl, A., Yeatts, S.D., Yan, B., Cockroft, K., Goyal, M., Jovin, T., Khatri, P., Meyers, P.,
Spilker, J., Sugg, R. and Wartenberg, K.E., 2015. Impact of general anesthesia on safety
and outcomes in the endovascular arm of interventional management of stroke (IMS) III
trial. Stroke, 46(8), pp.2142-2148.
Chen, C.J., Ding, D., Starke, R.M., Mehndiratta, P., Crowley, R.W., Liu, K.C., Southerland,
A.M. and Worrall, B.B., 2015. Endovascular vs medical management of acute ischemic
stroke. Neurology, 85(22), pp.1980-1990.
Goyal, M., Demchuk, A.M., Menon, B.K., Eesa, M., Rempel, J.L., Thornton, J., Roy, D., Jovin,
T.G., Willinsky, R.A., Sapkota, B.L. and Dowlatshahi, D., 2015. Randomized assessment
of rapid endovascular treatment of ischemic stroke. New England Journal of
Medicine, 372(11), pp.1019-1030.
Kobayashi, A., Czlonkowska, A., Ford, G.A., Fonseca, A.C., Luijckx, G.J., Korv, J., de la Ossa,
N.P., Price, C., Russell, D., Tsiskaridze, A. and Messmer‐Wullen, M., 2018. European
Academy of Neurology and European Stroke Organization consensus statement and
practical guidance for pre‐hospital management of stroke. European journal of
neurology, 25(3), pp.425-433.
Menon, B.K., Qazi, E., Nambiar, V., Foster, L.D., Yeatts, S.D., Liebeskind, D., Jovin, T.G.,
Goyal, M., Hill, M.D., Tomsick, T.A. and Broderick, J.P., 2015. Differential effect of
baseline computed tomographic angiography collaterals on clinical outcome in patients
enrolled in the interventional management of stroke III trial. Stroke, 46(5), pp.1239-1244.
Powers, W.J., Rabinstein, A.A., Ackerson, T., Adeoye, O.M., Bambakidis, N.C., Becker, K.,
Biller, J., Brown, M., Demaerschalk, B.M., Hoh, B. and Jauch, E.C., 2018. 2018

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guidelines for the early management of patients with acute ischemic stroke: a guideline
for healthcare professionals from the American Heart Association/American Stroke
Association. Stroke, 49(3), pp.e46-e99.
Rivkin, M.J., Bernard, T.J., Dowling, M.M. and Amlie-Lefond, C., 2016. Guidelines for urgent
management of stroke in children. Pediatric neurology, 56, pp.8-17.
Smithard, D.G., 2016. Dysphagia management and stroke units. Current physical medicine and
rehabilitation reports, 4(4), pp.287-294.