Assignment Detail:- NURS2003 Contexts of Health and Disease - The University of Sydney
Assignment - Case Study
CASE STUDY:
Fred Black is a 78-year-old man who lives with his wife Joan in a small rural town 60 kilometres south of Adelaide- Both Fred and Joan are independent with 3 children who all live interstate and they see them once or twice a year- Both Fred and Joan are very social and like getting together with their friends- Fred plays bowls three times a week and then joins his friends at the local club for lunch-
Fred was shaving a week ago when he noted that the left side of his face was drooping- His left arm felt very weak, and he tried to call out to Joan, but he could not speak properly- Fred fell to the floor, and Joan found him shortly after and immediately called an ambulance-
Fred was taken to the Emergency Department where on arrival he had a BP of 190/91, HR 115, RR 24, SaO2 95% on room air and a temperature of 37-2- He was immediately sent for a CT head and diagnosed with a CVA-
Fred's past medical history includes hypertension, hypercholesterolemia, Diabetes Mellitus, GORD, Atrial Fibrillation and a cholecystectomy 5 years ago-
Fred was transferred to the neurological ward- On assessment he had a GCS of 13, left sided hemiplaegia, expressive dysphasia, dysphagia & blurred vision in his left eye- He was scheduled to see the speech pathologist and the physiotherapist-
After a week of therapy Fred is ready to be discharged to a rehabilitation environment- He still has some residual dysphasia, but the dysphagia and blurred vision have largely resolved-
He still has significant weakness on his left side and discharge medications included:
Apixaban 5 mg PO daily
Ezetimibe 10 mg PO daily
Digoxin 125 mcg PO daily
Perindopril 2 mg PO daily
Simvastatin 40 mg PO daily
Amlodipine 10 mg PO daily
Provide a response to the following questions, percentages are provided to guide your word count:
Question 1- Identify the most likely aetiology of Fred's CVA- Explain how and why this can lead to a CVA from a pathophysiological perspective-- Include the pathophysiology of Fred's CVA-- In other words, discuss the pathogenesis of the most likely cause and how it can lead to CVA in relation to Fred's case-
Question 2- Identify two -2-other risk factors that Fred has that may contribute to a CVA- For each of these risk factors explain how & why they increase the risk of a CVA-
Question 3- Select two -2- signs and/or symptoms that Fred has as a result of his CVA- For each sign/symptom explain how and whyit occurs, from a pathophysiological perspective-
Question 4- Select three -3- of Fred's medications and explain why each of these are ordered-- Include the pharmacodynamics and pharmacokinetics of each medication, relevant adverse effects, contraindications, and nursing considerations-
Question 5- All Fred's medications are administered orally- Explain what the first pass is and the implications this has for a drug's bioavailability-
Attachment:- Contexts of Health and Disease-rar
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