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Pathophysiology template and answer the question ( Follow the example to finish it) Essay

  • Category:
    Nursing
  • Document type:
    Essay
  • Level:
    Undergraduate
  • Page:
    3
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    1676

Part 1: Patho physiological Process Template

Disease:

Stroke is one of the leading causes of death in the world and has been a major challenge to physicians for quite a long time. Stroke is generally a neurovascular condition that results into damage of blood vessels in the brain (Finsterer, 2012). There are two major types of stroke, which include the ischemic and hemorrhagic stroke.

Definition:

Ischemic stroke is a type of stroke where brain tissue is destroyed as a result of occlusion of a cerebral artery affecting the left cerebral hemisphere. This type of stroke is therefore associated with clogging of blood vessels rather than haemorrhage as experienced in patients with haemorrhagic stroke (Porth, 2009).

An affected left hemisphere will depict an infarction of the lateral temporoparietal regions bilaterally. This illustrates that many vessels have been blocked which may otherwise suggest emboli (Porth, 2009). The functional changes therefore are related to the extent of occlusion of the left hemisphere, which is categorised into speech changes, and that of movement of the right limbs.

Aetiology:

Most stroke cases are as a result of blockage or constriction of blood vessels that carry blood to the brain (Choi et al., 2012). As a result, there are various causes of stroke mostly associated with causing clotting of blood within the arteries or even narrowing of arteries in the left cerebral hemisphere of the brain. For instance, common consumption habits like a lot of fat consumption and even smoking might eventually lead to ischemic stroke.

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The above illustration takes the example of an uncontrolled consumption of fatty foods or high cholesterol food by the patient that eventually leads to stroke.

Structural changes of Mr. Black

-Right facial droop

-Paralysed right arm

-Weakened right leg

Functional changes Mr. Black

-Difficulty in speech

-Slow reflex in right knee

-Reduced sensation in right part of the body

Clinical Features:

The following are some of the manifestations of stroke:

  • Loss of balance or coordination

  • Difficulty in speech

  • Weaknesses or numbness in body parts e.g arms, legs, face etc

  • Blurred vision

  • Severe headache that may be accompanied by dizziness and vomiting (Choi et al., 2012).

Course of Disease:

A major warning signal of ischemic stroke is the transient ischemic attack (TIA) which might show for few minutes. Usually, stroke patients might start showing early signs that might come in the form of mild headaches. Eventually, this might lead to severe headaches, numbness and then complete manifestations of stroke (Choi et al., 2012).

Complications:

  • Loss of movement in muscular function leading to paralysis

  • Complications in swallowing and speech

  • Memory loss

  • Behaviour change

  • Pain, numbness etc ((Finsterer, 2012).

Prognosis:

As a result of the complications mentioned above, a patient with ischemic stroke is likely to be incapacitated and hence not able to competently carry out normal duties. The patient is also likely to be socially withdrawn.

Diagnosis:

Common tests procedures include:

  • Physical examination

  • Blood tests

  • Carotid ultrasound

  • Cerebral angiogram (Alkali, 2013).

Treatment:

As a result, the practitioners should be quick to prevent further clotting or narrowing of blood vessels. There are various drugs and procedures done to the patient to ensure the situation is contained (Thomassen et al., 2012). Drugs include Aspirin and intravenous injection of TPA. Procedures may include mechanical clot removal through surgery.

Prevention:

  • Lowering consumption of cholesterol

  • Avoiding excessive smoking and alcohol consumption

  • Regular physical exercises

  • Healthy feeding

  • Controlling high blood pressure (Finsterer, 2012).

Part 2: Case study questions

Question 1:

Mr. Black has been historically been diagnosed with hypertension which was 10 years ago. The patient’s history of having high blood pressure is also a pointer to the situation he has found himself in. High blood pressure is a major risk factor (Beckett et al., 2008); for the development of stroke. Since high blood pressure is basically a condition resulting from affected circulatory system which includes blocked vessels (Murray, Buttner & Price, 2012)., it is common to find that the arteries supplying the left hemisphere of the brain with blood are affected. The patient should have taken care of his health having been diagnosed with this circulatory condition. As a result, the patient’s blood vessels continued to be affected without watch which led to clogging of the left hemisphere of his brain and hence paralysis recorded. Secondly, the patient has continued to smoke despite being susceptible to high blood pressure.

Excessive nicotine content in the patient’s blood might be a big problem for the patient just like any other suffering from or at risk of getting stroke. Nicotine results into the constriction of the arteries in the brain and especially in the left hemisphere, which is of interest to this paper. As a result, there was a constant pressure pilling up on the patient’s arteries that resulted into restricted supply of blood into the left part of the brain. The left cerebral hemisphere is responsible for coordination and speech. As a result, the patient’s ability to speak has been affected and in addition, the patient’s right muscles and limbs are uncoordinated because of the balance of the nervous system that has been negatively impacted on by the patients’ condition.

It is also important to point out that the patient is a social drinker. Alcohol content in the patient’s blood is a victim of worsening his condition. This consumption habit is also responsible for pilling up pressure into the patient’s circulatory system. Alcohol is closely related to the clotting of blood in vessels, which puts patients at risk of Ischemic stroke. Heavy consumption leads to high alcohol levels in the blood, which in turns greatly affects the composition of the drinker’s blood. Formation of clogs and clots is subsequently disastrous to the patient’s health (Turanjanin et al, 2012). When such clogs are found in the left hemispherical arteries of the brain, this important part of the brain is deprived of oxygen supply because of the blockage in circulation.

As a result, the left cerebral hemisphere is not able to perform its function resulting into physical and structural alterations as experienced in the case of Mr. Black. It is also important to point out that the patient’s heart condition that led to stroke is hereditary; his father having been reported to have died from heart attack.

Question 2:

Mr. Black is not able to speak comfortably apart from paralysis of his right side of the body. The patient is however highly sensitive in the left side of the body. The patient’s lack of reflex on the right side of the body is also indicative of severe stroke as initially indicated by emergency practitioners. First, paralysis is a major symptom of stroke. Since the brain functions of coordination and reflex has been affected by the blocked arteries, the patient is not able to properly coordinate his right limbs. The numbness is therefore as a result of loss of reflex activity in the patient’s right body organs. Secondly, the patient is not able to competently speak. The left hemisphere that has been affected through a lack of oxygen supply is also responsible for coordination of speech (Larsson, Virtamo and Wolk, 2011). An interruption of its normal operations has therefore led to the patient’s incomplete speech as reported in the diagnosis report.

Question 3:

Mr. Black is therefore a victim of blocked arteries in the brain. As a result, it is important to understand the action of the two drugs; Alteplase and Assasantin as recommended by doctors in the case. It is prudent to state that the best way to ensure that Mr. Black is rescued from this life threatening condition is through an immediate prevention of the clotting and subsequent blockages in the arteries (Balasubramanian et al., 2010). As a result, the two drugs must be seen to be competently and effectively able to provide this intervention. First, Assasantin is an aspirin and dipyridamole rich medicine that has an ability of dissolving the clots in blood vessels that result in blocking of arteries. The medicine works effectively to prevent platelets from their tendency of blocking blood vessels. As such, Mr. Black will be able to be assisted by this drug in the event that he properly takes it as prescribed.

Secondly, Alteplase works well to prevent clotting through production of an enzyme that dissolves fibrin within the clots. By dissolving the clots, the vessels will be able to circulate blood to the left part of the brain. As a result, there will be sufficient flow of oxygen and nutrients to the brain cells and hence normal functioning enabled. Mr. Black’s condition therefore requires the two actions that will be provided for by the two prescribed drugs (O’Regan et al., 2008).

References

Alkali, N. (2013). Stroke Risk Factors and Sub Types. Nigerian Medical Journal, Vol. 54 Issue 2, p129-135.

Balasubramanian, S et al. (2010). Robot-assisted rehabilitation of hand function. Current Opin Neurol.
23 (6): 661–70.

Beckett NS, et al. (2008). Treatment of Hypertension in Patients 80 Years of Age or Older. N. Engl. J. Med.
358 (18): 1887–98

Choi, H et al. (2012). Stroke Units and Stroke Care Services. International Journal of Stroke, Vol. 7 Issue 4, p336-340.

Finsterer, J. (2012). Stroke and Stroke like Episodes in Muscle Disease. Open Neurology Journal, Vol. 6, p26-36.

Larsson, S. C.; Virtamo, J & Wolk, A. (2011). Red meat consumption and risk of stroke in Swedish men. American Journal of Clinical Nutrition
94 (2): 417–421.

Murray ED, Buttner N, Price BH (2012). «Depression and Psychosis in Neurological Practice». In Bradley WG, Daroff RB, Fenichel GM, Jankovic J. Bradley’s neurology in clinical practice.
1 (6th ed.). Philadelphia, PA: Elsevier/Saunders

Porth, C. (2009). Pathophysiology : concepts of altered health states. 8th ed., International ed. Lippincott Williams & Wilkins. Print

O’Regan C, et al. (2008). Statin therapy in stroke prevention: a meta-analysis involving 121,000 patients. Am. J. Med.
121 (1): 24–33.

Thomassen, L et al. (2012). Acute Stroke Center- the Changing focus. Acta Neurologica Scandinavica, Vol. 125 Issue 6, p410-415

Turanjanin, N et al. (2012). Frequency of Ischemic Stroke Subtypes in Relation to Risk Factors for Ischemic Stroke. HealthMed. Vol. 6 Issue 10, p3463-3468.