The Nursing Assessments Discussion Paper
Question
Mr. James Hobson is a 69-year-old male with a history of hypertension that is well controlled on medication.
He has been smoking 1 or 2 packs of cigarettes a day for the past 52 years and has a body mass index of 37.3. He awoke yesterday morning complaining of blurry vision and some weakness on the left side of his body. He thought he had just slept wrong, so he was not concerned. Later in the morning he was having trouble walking and his wife convinced him to call his physician.
The physician’s office called 911, and Mr. Hobson was transported to the nearest hospital. Upon arrival to the emergency department the physical etam findings were- HR 112 beats/min, BP 172/90 mm Hg, RR 24 breaths/min, O2 Sat 90%, leg arm and leg weakness (3/5), and somewhat decreased sensation. He was awake and responding to questions appropriately, though slowly.
The following diagnostics tests were ordered: noncontract CT (NCCT) of the head; ECG; CBC with platelets, cardiac enzymes, and troponin; electrolytes; BUN; creatinine; glucose; PT/INR; and PTT. This patient’s CT scan did not show any signs of hemorrhage.
Note: Currently, thrombolytics are administered to treat an ischemic stroke within 3 hours of symptom onset. Studies are underway to evaluate the safety and efficacy of extending this window to 4½ hours. Because it was unclear exactly when the symptoms began, the decision was made not to administer a thrombolytic.
Question: Discuss the nursing assessments for Mr. Hobson.
Expert Answer
Step-by-step
- Neurological assessment: This involves assessing his level of consciousness, pupil size, symmetry, and response to light, assessing his ability to speak, comprehension, and language ability. The nurse should also assess his strength, sensation, and coordination in all four limbs
- Vital signs: The nurse should monitor Mr. Hobson’s vital signs, including his blood pressure, heart rate, respiratory rate, and oxygen saturation.
- Vital signs: The nurse should monitor Mr. Hobson’s vital signs, including his blood pressure, heart rate, respiratory rate, and oxygen saturation. Cardiovascular assessment: The nurse should assess Mr. Hobson’s heart sounds, peripheral pulses, and capillary refill time. The nurse should also monitor for signs of chest pain, shortness of breath, or other cardiovascular symptoms monitor for signs of chest pain, shortness of breath, or other cardiovascular symptoms
- Respiratory assessment: The nurse should assess Mr. Hobson’s breathing pattern and lung sounds. The nurse should also monitor for signs of respiratory distress or hypoxia.
- Fluid and electrolyte assessment: The nurse should monitor Mr. Hobson’s fluid intake and output, as well as his electrolyte levels. The nurse should also assess for signs of dehydration or electrolyte imbalances.
- Fluid and electrolyte assessment: The nurse should monitor Mr. Hobson’s fluid intake and output, as well as his electrolyte levels. The nurse should also assess for signs of dehydration or electrolyte imbalances. Skin assessment: The nurse should assess Mr. Hobson’s skin for signs of pressure ulcers, bruising, or other injuries.
- Skin assessment: The nurse should assess Mr. Hobson’s skin for signs of pressure ulcers, bruising, or other injuries.
- Psychosocial assessment: The nurse should assess Mr. Hobson’s emotional state and provide emotional support for him and his family.
- Medication management: The nurse should administer medications as ordered, monitor for adverse reactions, and educate Mr. Hobson about his medications.
- Safety assessment: The nurse should assess Mr. Hobson’s risk of falls, implement fall prevention measures, and monitor him for any safety concerns.
- Education: The nurse should educate Mr. Hobson and his family about stroke prevention measures, signs and symptoms of stroke, and the importance of follow-up care
- Neurological assessment: This involves assessing his level of consciousness, pupil size, symmetry, and response to light, assessing his ability to speak, comprehension, and language ability. The nurse should also assess his strength, sensation, and coordination in all four limbs.
- Vital signs: The nurse should monitor Mr. Hobson’s vital signs, including his blood pressure, heart rate, respiratory rate, and oxygen saturation.
- Cardiovascular assessment: The nurse should assess Mr. Hobson’s heart sounds, peripheral pulses, and capillary refill time. The nurse should also monitor for signs of chest pain, shortness of breath, or other cardiovascular symptoms.
- Respiratory assessment: The nurse should assess Mr. Hobson’s breathing pattern and lung sounds. The nurse should also monitor for signs of respiratory distress or hypoxia.
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- Fluid and electrolyte assessment: The nurse should monitor Mr. Hobson’s fluid intake and output, as well as his electrolyte levels. The nurse should also assess for signs of dehydration or electrolyte imbalances.
- Skin assessment: The nurse should assess Mr. Hobson’s skin for signs of pressure ulcers, bruising, or other injuries.
- Psychosocial assessment: The nurse should assess Mr. Hobson’s emotional state and provide emotional support for him and his family.
- Medication management: The nurse should administer medications as ordered, monitor for adverse reactions, and educate Mr. Hobson about his medications.
- Safety assessment: The nurse should assess Mr. Hobson’s risk of falls, implement fall prevention measures, and monitor him for any safety concerns.
- Education: The nurse should educate Mr. Hobson and his family about stroke prevention measures, signs and symptoms of stroke, and the importance of follow-up care The Nursing Assessments Discussion Paper