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Case Study, Chapter 67, Management of Patients With Cerebrovascular Disorders
Penny Williams, a 74-year-old patient, is admitted to the telemetry unit with the diagnosis of acute
ischemic stroke. The patient is experiencing paroxysmal atrial fibrillation with a controlled ventricular
rate on the monitor.A CT of the head without contrast reveals no evidence of hemorrhage. The transesophageal
echocardiogram reveals moderate mitral valve insufficiency and embolism as a primary cause of the
stroke. The patient is on aweight-based heparin protocol. The patient received digitalis to keep the ventricular rate of the atrial
fibrillation controlled. The patient has right-sided paralysis and global aphasia. The patient has unilateral
neglect of her right side and has right field homonymous hemianopsia. Papilla edema is present bilaterally.
The patient is drooling from the right side of her mouth and coughs periodically. The patient was found by
her daughter when she got home from work. The daughter stated her mother was normal before she left
for work, and 10 hours later the mother exhibited the symptoms described above. The time of onset for the
stroke could not be safely determined so no interventions could be used to treat the stroke. (Learning
Objective 4)What principles of nursing management should the nurse provide the patient during the acute stage of theischemic stroke based on the assessment findings from the case study? Place the assessment findings
that are supported by the nursing principle(s) in parenthesis.
Sample Solution
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