Why is a particular cue or subset of cues of concern

Reference no: EM133647880

Case Study: CVA

E.F. 82-year-old male with history of CAD, Type 2 DM, Seizures, Hyperlipidemia, DVT, BPH, Osteopenia. Presented to the Emergency Room after daughter noticed he was having problems finding his words. Then he was having a hard time using the computer mouse. Then his face started to droop on the right. These symptoms occurred over the last two days.

Home medications:

- Amlodipine - Benazepril (Lotrel) 10-40mg once a day

- Aspirin 81 mg once a day

- Lantus Insulin 15 units SQ at bedtime

- Levetiracetam (Keppra) 250 mg twice per day

- multi-vitamin once per day

- Naproxen (Aleve) 220 mg PRN

- Quetiapine (Seroquel) 25 mg tablets - 1/2 tablet twice a day.

Vital Sign at ED:

990F orally, HR: 100, RR: 16, BP 149-87, SpO2 97%

Initial assessment reveals expressive aphasia, right sided hemiparesis, and facial droop.

NIHSS score is 15:

- LOC - 2

- Commands - 1

- FP - 1

- RUE - 4

- RLE - 2

- Language - 3

- Dysarthria - 2

1. Recognize cues (Priority Assessment findings)

a. What information is relevant/irrelevant?

b. What information is MOST important?

c. What information is of immediate concern?

2. Analyze Cues

a. What client conditions are consistent with the cues? Are there cues that support or contraindicate a particular condition?

b. why is a particular cue or subset of cues of concern?

c. What other information would help establish the significance of a cue or set of cues?

3. Prioritize Hypotheses

a. Which explanations are most/least likely?

b. Which possible explanations are the most serious?

4. Generate Solutions (Planning care)

a. What are the desirable outcomes?

b. What interventions can achieve those outcomes?

c. What should be avoided?

5. Take Action (Priority Interventions)

a. Which intervention or combination of interventions is most appropriate?

b. How should the interventions be accomplished? (this includes ACTION, communication, administration, interdisciplinary collaboration, etc.)

6. Evaluate outcomes

a. What signs would point to improving/declining/unchanged status?

b. How would you determine if interventions were effective?

c. If interventions were ineffective, what would be the next steps?

Reference no: EM133647880

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