Reference no: EM133384837

Mr Spooner found his wife, Vivian, 76 years, lying on the bedroom floor when he arrived home in the evening. He was unable to rouse her fully or get her to move, and called an ambulance.

On arrival at the Emergency Department, Mrs Spooner responded to loud verbal commands with unintelligible sounds. She moved her left arm and leg purposefully to painful stimuli, but her right limbs were flaccid, and her reflexes reduced. Her pupils were equal and reacting to light sluggishly.

Mrs Spooner's vital signs were pulse 90/min, BP 170/100, resp 18/min, temp 36.7°C. Her skin was pale, her coughing and swallowing reflexes were reduced. Oxygen therapy was continued, an intravenous infusion and nasogastric tube inserted. A provisional diagnosis of stroke was made and Mrs Spooner was sent for a CT scan. A diagnosis of ischaemic stroke due to a thrombus of the left middle cerebral artery was made following the CT scan.

Discuss the ongoing monitoring considerations for Mrs Spooner.