Discussion Week 6-gates CVA-University of South Florida NUR 3081
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Course
DKA, CVA
Institution
DKA, CVA
Discussion Week 6-gates CVA-University of South Florida NUR 3081
(CVA) History of Present Problem:
John Gates is a 59-year-old male with a history of diabetes type II and hypertension who was at work
when he had sudden onset of right-sided weakness, right facial droop, and difficulty speaking....
Primary Concept
Perfusion
Interrelated Concepts (In order of emphasis)
1. Stress
2. Coping
3. Clinical Judgment
4. Patient Education
FUNDAMENTAL Reasoning: STUDENT
Cerebral Vascular Accident
(CVA) History of Present Problem:
John Gates is a 59-year-old male with a history of diabetes type II and hypertension who was at work
when he had sudden onset of right-sided weakness, right facial droop, and difficulty speaking. He was
transported to the emergency department (ED) where these symptoms continue to persist. It has been one
hour from the onset of his neurologic symptoms when he presents to the ED. You are the nurse
responsible for his care.
Personal/Social History:
John lives with his wife in their own home in a small rural community. He owns a hardware store where
he remains active and involved in the day-to-day operations. His wife insists on being by his side and
talking to John despite John’s frustration in not being able to answer her questions. His wife reports that
the past week he has been complaining of episodes where his heart felt as if it was beating irregularly and
fast but then resolved. His wife also states that he has been complaining of pain in his right foot the past
week. John has been trying to quit smoking the past month and has been using a nicotine patch. His wife
reports that he does not regularly check his blood glucose and eats what he wants. He is 6 feet tall and
weighs 250 pounds (113.6 kg/BMI of 33.9).
What data from the histories are RELEVANT and has clinical significance to the nurse?
RELEVANT Data from Present Problem: Clinical Significance:
Sudden onset of right-sided weakness, right Patient is exhibiting symptoms of Cerebral Vascular accident and
facial droop and difficulty speaking. neurological changes that related to a disruption in blood flow to the left
hemisphere of brain.
60 minutes have passed since onset of
symptoms It is critical to figure out what type of stroke hemorrhagic stroke or
ischemic stroke to act quickly to prevent more damage and to evaluate
appropriateness of Thrombolytic therapy (tPA). (Nettina & Brunner,
2019, pp. 364-372)
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