Elderly Stroke Patients: A Case Study

Experienced nurses find ways of incorporating oral care into regular assessments – combining the two encourages performing the oral hygiene care and saves time. Dale, et al. (2016) quoted an un-named ICU administrator who commented, “I would hope that they are teaching (mouth care) in the critical care curriculum.” Stressing the importance of oral care early in the training of a new critical care nurse should help to solidify the inclusion of oral care into regular daily practice.

As a nurse in a skilled nursing facility, oral hygiene care is very important, but the importance significantly increases when our patients are functionally dependent or cognitively impaired. These patients are unable to perform this task and depend on nurses to provide daily care. Nurses need to pay close attention for potential problems. They will need to perform assessments, develop oral care plans, and identify preventions and strategies to eliminate any potential problems. Poor oral health has been linked to serious systemic illnesses including diabetes mellitus, stroke, hypertension, myocardial infarction and aspiration pneumonia (Dyck et al., 2012). Patients who suffer from a lack of oral care can have a dramatic impact to their

Strokes are caused by a block in the blood supply to the brain which causes a decrease in oxygen and delivery of other important supplies which facilitate proper functioning. Fifteen million cases are reported worldwide annually, although not all of these cases are mortalities, the large prevalence of strokes ranks it as the fourth leading cause of death in the United States. (Figueroa) Because of the time sensitivity associated with the lack of resources to the brain, strokes are considered a medical emergency and early recognition of symptoms can help decrease the amount of damage caused . Although strokes do not always cause death, strokes most often leave the individual with some physical and cognitive impairment.

The purpose of this essay is to discuss a clinical skill or nursing action by referring to the nursing and allied health literature to explain and support evidence based practice. The skill I wish to examine is the practice of oral hygiene for adults with dementia in residential aged care facilities. In this essay I aim to provide the reader with adequate references to support the best practice for oral hygiene for people with dementia.

3000 word essay on patient with left sided stroke with one identified health need/problem: Dysphagia

As society continues to age, one fourth of the world will be 65 years or older, thanks to the influx of baby boomers. Due to this rapid growth in longevity, this will multiply the problem of access to care. Attention towards systemic conditions such as Alzheimer’s disease, cardiovascular disease, diabetes, and strokes are being discussed by government agencies and health care professionals. (Overview of oral health, 2017). There is evidence linking oral health to systemic health, therefore, a need for a more collaborative approach towards prevention is critical to achieve overall health for the public (Jin, 2016).

Mrs. Alice Palmer is a 54-year old married woman who has been admitted and is being treated with an ischemic stroke which she had 18 hours ago. This paper explores the nursing care of Mrs. Alice Palmer based on the clinical reasoning cycle by considering her situation first, collecting cues and information about her, processing the information gathered, then identifying problems or issues she is experiencing, and finally carrying out a detailed assessment. Also, the paper focuses on setting goals and establishing a nursing care plan in the community, and target ethnically safe practice. Ischemic stroke occurs when the brain tissue does not receive sufficient oxygenated blood due to an obstruction of the carotid artery (Brunner, Suddarth, & Smeltzer, 2008). When the brain does not receive enough oxygenated blood, some or all of its tissues may get damaged

Evidence-Base practice (EBP) is defined as based on problems identified from nursing practice; using best evidence and professional expertise and merging them into current practice to ensure patients receive quality care (French, 1999). Evidence-based practice is a part of quality improvement process; it is made of evidence, clinical expertise, patient preference and the context of care (Barker, 2013). In brief, evidence-based practice is the guideline in the nursing practice that requires nurses gather and use clinical evidence to help diagnose or assess patients correctly by using their knowledge and experience in order they can deliver the quality of care to the patients (Ellis, 2013). In the other words, in the nursing practice the clinical evidence supports all the nursing procedures performed.

Strokes are one of the major causes of immobility in seniors. Recovery largely depends on the extent of the brain injury and the length of time before treatment. Nonetheless, most seniors require the assistance of a caregiver and this mainly requires planning and organization. Here are some ways you can take care of a senior post -stroke

Given the high risk of severe, debilitating health outcomes imaging a patient with suspected stroke in a timely fashion is paramount. When the timing of the stroke onset is determinable this allows for the appropriate form of treatment to be administrated such as thrombolytic therapies and neurointerventional techniques (González, 2012).

The existing, big competition on healthcare market, where the hospital reimbursement depends partially on the patients’ outcome and satisfaction, forces each hospital to stay on the top of newest evidence-based practices (EBP). This standard applies not only to physicians and the treatments they offer, but also to nursing care provided to the patients.

As stated in Acute Stroke Intervention (Prabhakaran, Ruff, & Bernstein, 2015), one of the leading causes of death and disability in the United States are strokes. Acute ischemic stroke (AIS) results when an artery that is supplying the brain becomes blocked, this occurrence leads to cell death of brain tissue. Improving brain function after an ischemic stroke is of high priority for clinical research. General consensus shows that administration of intravenous recombinant tissue plasminogen activator (IV rtPA) therapy is helpful when introduced within 4.5 hours of ischemic stroke symptom onset. The benefit of intravenous (IV rtPA) lessens when the onset of symptoms goes beyond 4.5 hours. The use of (IV rtPA) is contraindicated when there is

Stroke is a severe medical condition and is the number five cause of death and leading cause of serious, long-term disability in America. There are three main kinds of stroke, ischemic which is caused by blood blots, hemorrhagic which is caused by ruptured blood vessels that cause brain bleeding, and transient ischemic attack (TIA) which is a “mini-stroke” caused by a temporary blood clot. It is well-known that brain cells die after a few minutes when they are no longer able to receive nutrients and/or oxygen from the blood or even when there is sudden bleeding in and around the brain. After the brain cells die, the part of the body that they control will no longer be able to function. The signs and symptoms depends on the

odour, changes in voice and any difficulty or pain on swallowing. Assessing a patients should not only involve a nurse, but the member of the multidisciplinary team. The physiotherapy, dietitian, speech and language therapist, occupational therapist and the doctors involves in the patients care. Who all play an important role. A study was carried out by Horne et al (2014) to investigate the organisation, provision and practice of oral care in typical UK 11 stroke units; and explore stroke survivors’, carers’ and healthcare professionals’ experiences and perceptions about the barriers and facilitators to receiving and undertaking oral care in stroke unit. The senior nurse on each of the 11 stroke units completed and returned the questionnaire.

The over the counter medication once known only for its ability of easing aches and pains or fighting off fever and inflammation is proving itself to be quite the miracle drug. Aspirin has become part of the protocol for stroke victims as a preventative measure due to its neuro-protective benefits. Stroke can cause lesions in cerebral white matter, which may result in cognitive impairments such as deficits in learning and memory. White matter lesions (WML) have also been linked to increasing the risk of post-stroke dementia. Cerebral white matter damage has been widely overlooked. Comprised of oligodendrocytes that form the insulating myelin in the CNS, white matter is evidentially just as vulnerable to ischemia as gray matter.