[Answered]: Cose Study 4 Mrs

Cose Study 4 Mrs. Bloom is a 57-year-old female who presented to the Emergency Room with new onset Atrial Fibrillation with Rapid Ventricular Response (RVR). She is admitted to the cardiac telemetry unit after being converted to normal sinus rhythm with a calcium channel blocker (diltiazem). When you enter the room to assess Mrs. Blossom, her daughter looks at you concerned and says “mom’s acting kinda funny”. What nursing assessments should be a priority? Vital signs and neuro assessment You assess Mrs. Bloom to find she has a left sided facial droop, slurred speech, and is unable to hold her left arm up for more than 3 seconds. 2. What is/are your nursing priorities at this time? Call Rapid Response Team and initiate stroke protocols 3. What may be happening to Mrs. Bloom? She is having a stroke You activate a Code Stroke and notify the charge nurse for help. You obtain suction to have at bedside just in case. The neurologist arrives at bedside within 7 minutes to assess Mrs. Blossom. He notes her NIH Stroke Scale score is 324 He orders a STAT CT scan, which shows there is no obvious bleed in the brain. 4. What are the possible intervention for Mrs. Bloom at this time? 5. What are the contraindication for thrombolytics like SPA ? You administer tPA per protocol, initiate q15min vital signs and neuro checks. You stay with the patient to continue to monitor her symptoms. 6. What are the possible complications of tPA administration?’ What should you monitor for? After 2 hours, Mrs. Blossom is showing signs of improvement. She is able to speak more clearly. though with a slight slur. She is still slightly weak on the left side, but is able to hold her arm up for 10 seconds now. Her NIHSS is now 6. Mrs. Blossom’s daughter asks you why this happened. 7. What would you explain has happened to Mrs. Elloomphysiologically? MacBook Air