Reference no: EM133606000
Assignment:
A 61-year-old woman arrived in the ED and is being evaluated for suspected stroke. Her family reports that they last saw her normal 2 hours ago.
a. What steps can you take to ensure rapid evaluation and treatment?
b. What are your priorities for her care?
c. If she is found to be eligible for t-PA and/or intra-arterial thrombolysis, how will your priorities change?
Melvin Strong, a 19-year-old patient, presents to the emergency department after being ejected from an automobile. He has a backboard with a cervical collar in place. The EMT stated that when he saw the patient, the patient was unconscious but quickly gained consciousness and was oriented ×3, talking, and able to move all four extremities. Within 5 minutes, the patient became unable to be aroused, opened his eyes only to painful stimuli, made incomprehensible sounds, and withdrew from pain. The vital signs are: temperature, 100°F; blood pressure, 180/50 mm Hg; heart rate, 50 bpm; and respiratory rate, 14 breaths/min. The left antecubital IV site has NS at 125 mL/h. The EMT stated that the patient complained of a severe headache and had an episode of projectile vomiting before the neurologic decline. The patient's breath smells like alcohol. When the patient arrived, the nurse noted that the patient's pupils were unequal---the right pupil was larger than the left pupil---but both pupils reacted to light accommodation.
a. What do the assessment findings suggest?
b. What signs and symptoms does the patient exhibit related to increased intracranial pressure?
c. What medical and surgical treatment does the nurse anticipate for the patient?
d. What Glasgow Coma Scale (GCS) did the patient have initially at the scene of the injury? What GCS did the patient have when he began deteriorating neurologically?
e. What nursing interventions should the nurse provide?