Management of a Patient with Neurologic Dysfunction

Medical-Surgical Case Studies Case Study #1

Management of a Patient with Neurologic Dysfunction J.M., a 22-year-old male patient who weighs 150 pounds, presents to the emergency department (ED) after being thrown from his horse and passing out for a few minutes, after which he regained consciousness. A friend with whom he was riding witnessed the fall and called for help. Upon initial assessment, J.M. was found to have a GCS of 15 with a normal neuro exam.

The ED physician wrote orders for a CT scan without contrast of the head, a CBC, renal and metabolic profile, PT, PTT, and an INR. The nurse sent the labs and had the IV of Normal Saline at a keep-open rate per the ED protocol. The nurse was awaiting radiology to call for the patient to go for the CT when the patient had an “epileptic cry,” became unconscious, stiffened his entire body, and then had violent muscle contractions.

J.M.’s respirations became very shallow, and his lips and nail beds became blue. Furthermore, he lost control of his bowel and bladder functions. Blood was oozing from his mouth due to J.M. Having bitten down on his tongue. The radiology department has called to say they are ready for J.M. to come for the CT scan.

1. List in the correct order of priority the actions that should be taken by the nurse while the patient is actively seizing. 2. Explain What type of seizure is occurring and describe the three phases of seizure activity? Describe specific nursing care for each stage.

3. The ED physician orders the following: Valium (diazepam) 10 mg every 10 to 15 minutes prn for seizures (to a maximum dose of 30 mg). Once seizures stop, administer Dilantin (phenytoin) 10 mg/kg IVPB [The RN will be administering this IV medication], continuous ECG monitoring, VS, GCS, and neuro checks at least every 30 minutes. Explain the rationale for all of the physician’s orders.

Case Study #2

Management of Patients with Multiple Sensory Deficits You have received a report on the new admission to your short-term rehabilitation unit. Mrs. Ida Henson is an 81-year-old female with left hemiplegia, left-side neglect, and left visual field deficit (homonymous hemianopsia) due to a stroke. She has a history of hypertension and insulin-dependent diabetes Mellitus (IDDM) and she wears bilateral hearing aids.

Prior to this event, she was an extremely active octogenarian, working daily as a volunteer at a local nursery, driving, helping family members, and socializing several times a week with friends. After several weeks of therapy, the physical therapy assistant cannot tell if Mrs. Henson is experiencing fatigue or if she doesn’t seem to be hearing instructions even though her hearing aids are in both ears.

1. Identify three initial nursing diagnoses for Mrs. Henson and list the defining characteristics that would support each of your identified nursing diagnoses. 2. What assessments would the nurse perform to assess Mrs. Henson’s hearing ability? 3. Upon further assessment, it is determined that Mrs. Henson has impacted cerumen. You receive an order for carbamide peroxide (Debrox) two drops each ear twice daily for 3 days to be followed by otic irrigation on day four.

What steps should be taken by the nurse to perform the otic irrigation? How will the nurse evaluate if the otic irrigation was successful? 4. What general overall strategies can the facility staff implement to optimize communication with Mrs. Henson in view of her hearing impairment and present health status?

Place your order
(550 words)

Approximate price: $22

Calculate the price of your order

550 words
We'll send you the first draft for approval by September 11, 2018 at 10:52 AM
Total price:
$26
The price is based on these factors:
Academic level
Number of pages
Urgency
Basic features
  • Free title page and bibliography
  • Unlimited revisions
  • Plagiarism-free guarantee
  • Money-back guarantee
  • 24/7 support
On-demand options
  • Writer’s samples
  • Part-by-part delivery
  • Overnight delivery
  • Copies of used sources
  • Expert Proofreading
Paper format
  • 275 words per page
  • 12 pt Arial/Times New Roman
  • Double line spacing
  • Any citation style (APA, MLA, Chicago/Turabian, Harvard)

Our Guarantees

Money-back Guarantee

You have to be 100% sure of the quality of your product to give a money-back guarantee. This describes us perfectly. Make sure that this guarantee is totally transparent.

Read more

Zero-plagiarism Guarantee

Each paper is composed from scratch, according to your instructions. It is then checked by our plagiarism-detection software. There is no gap where plagiarism could squeeze in.

Read more

Free-revision Policy

Thanks to our free revisions, there is no way for you to be unsatisfied. We will work on your paper until you are completely happy with the result.

Read more

Privacy Policy

Your email is safe, as we store it according to international data protection rules. Your bank details are secure, as we use only reliable payment systems.

Read more

4-hour deadlines

Your urgent tasks will be completed within 4 hours. Your discussion responses and late orders will be will be handled fast and we still maintain our quality.

Read more
error: