(NURBN 2022) Nursing assignment demonstrating knowledge and application of best evidence-based nursing practice in relation to right-sided ischemic cerebrovascular accident

Question

Task: Can you provide the essential nursing assessment, care required and evaluation pertinent to right-sided ischemic cerebrovascular accident in your nursing assignment

Answer

Introduction
A right-sided ischemic cerebrovascular accident (CVA) is a type of stroke that occurs on the right side of the brain. It can be caused by a blockage in arteries that carry blood to the brain (Hui, Tadi& Patti, 2022).In the nursing assignment, it can be seen that Julie Joseph is a 72-year-old women suffering from right-sided ischemic cerebrovascular accident (CVA). In this nursing assignment, in-depth discussion will be made on the disease and its other aspects. Prioritize and Facilitation of General Nursing Carein nursing assignment The nursing care required for Julie Joseph can becontroling of bleeding by direct pressure and elevation of the limb.Prevention of fluid and electrolyte loss by maintaining adequate oral intake, intravenous fluids, or other means (Hu et al., 2018).As per the nursing assignmentit is vital to maintaining body temperature to prevent hypothermia.Prevention and treatment of shock by administering oxygen, volume expanders such as intravenous saline solution, blood transfusion as required, and other measures appropriate for the patient's condition (Karaca&Durna, 2019). According to the nursing assignmentpain management is one of the most important aspects of treatment for patients with Right-Sided Ischemic Cerebral Vascular Accident (CVA). The right side of the brain controls the body's pain response. It might be difficult for Julie because she might not be able to communicate her pain levels (Morad& Farrokh, 2018).

It is to be considered in the nursing assignmentthat Julie is in a bad position. She may also suffer from speech problems. Julie will have a sudden onset of symptoms, including pain on one side of her head and numbness or weakness on one side of the body (Kasmaei et al., 2015). Her symptoms may lead to confusion and dizziness, which can make it difficult for her to walk or stand. She may also have difficulty speaking, swallowing or seeing out of one eye. These symptoms are often caused by a blockage in a blood vessel in the brain. Oxygen therapy and medication administration are two ways which can be used to help Julie as she is suffering from right-sided ischemic cerebral vascular accident. This can be used for Julie in the nursing assignmentif she is not able to get enough oxygen from the air that she is breathing in(Siemieniuk et al., 2018).

Prevention of Possible Hospital Acquired Complications
DVT prophylaxis is a treatment for deep vein thrombosis, which is a blood clot in the deep veins of the body(Badireddy&Mudipalli, 2018). These measures in the nursing assignmentwill be usually taken for three months, although they may be continued for up to twelve months if Julie faces multiple episodes of DVT, or if she develops other risk factors for developing another episode. Julie is given DVT prophylaxis in order to prevent deep vein thrombosis. Julie will also be prescribed anticoagulants to help keep her blood thin.

There are a number of pressure areas in the cases of right-sided ischemic cerebrovascular accidents (CVA). These include, the patient's general condition, the duration of the symptoms before treatment is started, the severity and extent of the symptoms. Falls injuries are a common and serious complication of right-sided ischemic cerebrovascular accidents (CVA). Since Julie has suffered the accident in the nursing assignment, she also might have to face such issues.

The reasons for falls in patients with right-sided CVA include reduced awareness of the environment due to sensory deficits, reduced ability to control balance, reduced muscle strength, and decreased mobility.Some risk factors for falls in this population include impaired cognition, impaired vision, and impaired hearing as per the nursing assignment. The most common complication that Julie might face is gastrointestinal hemorrhage, which is high in severity and can lead to death. Other complications might include acute pancreatitis, small bowel obstruction, and perforation of the bowel. Julie might face these GIT complications in the nursing assignmentdue to the increased risk of bleeding from a ruptured artery (Camilleri, 2021).

Promotion of Adequate Hydration and Nutrition in thenursing assignment
Julie might face the issue of decreased blood pressure and she may have low blood volume. She might also have high blood pressure and an increased heart rate. She needs to be given fluids intravenously, if she is not able to drink enough fluids orally (Roumelioti et al., 2018). If Julie can drink in the nursing assignment, then she should be encouraged to drink as much as possible and should be given oral rehydration salts (ORS) if necessary. Maintaining fluid balance will help Julie with healing and recovery after the accident as well as preventing post-surgical complications (Izzy et al., 2018).

The size and frequency of fluid in Julie’s case as per the details of the nursing assignmentis an important factor to be considered while diagnosing the severity. After the accident, there might be a blockage in the blood vessels of Julie on the right side of the brain which causes an interruption in blood flow and oxygen supply. This can lead to brain damage and stroke (Purushothaman et al., 2014).There is no specific dietary type for this condition but it is important for Julie to maintain a low-fat diet and have high levels of water intake.

Depending on whether there was an intervention or not, allied health input may include rehabilitation, occupational therapy, physiotherapy and speech therapy for Julie.

Assessments in the nursing assignmentmay include blood tests, imaging tests, and digestive analyzers. It is important to maintain a low fat diet and have high levels of water intake(Ferguson et al., 2020).

Provision of Emotional and Psychological Support in nursing assignment
The therapeutic nurse-patient relationship is important for Julie. The nurse can help Julie to cope with her anxiety and depression. They can also help her to deal with her altered lifestyle and provide emotional support (Xue& Heffernan, 2021). A nurse-patient relationship will provideJulie with emotional support and help her to feel safer in the environment as per the nursing assignment.

For Julie, the network can be her family members, friends, or colleagues. It will helpJulie to recover from the accident. The support network will also provide emotional and physical support to help Julie get better.
One allied health professional is a speech-language pathologist, who might perform tests on Julie to evaluate how well she can speak or understand speech. According to the nursing assignmentthey might also work with occupational therapists to evaluate whether Julie needs special equipment for daily activities like eating or dressing. Allied health professionals can also provide emotional support for Julie and her family members (Sharma et al., 2014). Julie may have a hard time dealing with the diagnosis of her accident. She may feel guilt, anger, sadness, or anxiety. Depression is a common issue that can arise from this diagnosis. Depression can make it difficult for Julie to complete tasks or spend time with friends and family members. Julie might also develop suicidal thoughts or actions. Julie might experience the following symptoms mentioned in the nursing assignmentlike nausea and vomiting, confusion and memory loss, headaches and dizziness, seizures, slurred speech, difficulty swallowing, and drooling. There are many personal issues that may arise due to diagnosis of this condition. Some of them are fear of death, loss of independence, loss of memory.

Education and Discharge planning
A succinct discharge is a document that will provide the essential information about Julie’s condition and treatment to the health care provider who will be caring for her (Jonnalagadda, 2020).To manage Julie’s condition in the nursing assignment, doctors will prescribe medications like aspirin and clopidogrel. These medications work by reducing the risk of clot formation and reducing inflammation. The medication management for Julie will include supportive care which includes intravenous fluids, blood pressure control with medications such as nitroglycerin or labetalol, and oxygen therapy if necessary (Parsay et al., 2021). The goal of medication management is to prevent further damage by reducing blood pressure and decreasing brain swelling. These can be done with antihypertensive drugs and antiplatelet drugs as per the nursing assignment. There are many medications used to treat this condition including aspirin, TPA (tissue plasminogen activator), and heparin (Sadeghi et al., 2014).

There are several equipments that can be used for Julie’s home treatment. These include a manual resuscitator: It is a device which will enable Julie to breathe manually by compressing the chest. A compression bandage: It is a type of bandage that is wrapped around an injured limb or body part to stop bleeding and swelling. According to the nursing assignmentJulie will need to have her blood pressure monitored and her heart rate checked. The patient should also be given oxygen and IV fluids if needed (Kalla et al., 2018).

Julie will also need to have an MRI or CT scan done as soon as possible, since this can help doctors identify any brain damage that has been caused by the injury.

The symptoms are symptoms of a stroke like dizziness, loss of balance or coordination, severe headache with no known cause. Community support services are available to help at home in Julie’s case. These services include the following, home care which is a service that will provide assistance to Julie, who is recovering from a stroke, at home. As per the nursing assignmentthe caregiver can provide assistance with personal care, meal preparation and other tasks that are needed for daily living (Mancini, 2018). Respite care which is a service that provides temporary relief for caregivers so they can take some time off from caring for their loved one or family member with stroke symptoms.Adult daycare which is a service that will provide Julie with an opportunity to socialize participate in activities and receive medical attention during the day while her caregiver takes some personal time (Dong et al., 2017).Case manager is a service that will help Julie and caregiver to coordinate their needs and organize her care between their hospital stay, family members, personal caregivers, social workers, physical therapists and other professionals (Hoda&Koziej, 2020).

Some predisposing factors for Julie’s condition mentioned in the nursing assignmentinclude: right-sided ischemic cerebral vascular accident dementia, pugilistica, multiple sclerosis vascular dementia. Cerebral ischemia can also be caused by a hemorrhage in the brain (Tay et al., 2020).

Conclusion
From the above nursing assignment, it can be concluded that a right sided ischemic cerebrovascular accident (CVA) is a type of stroke that affects the right side of the brain. It occurs when there is a blockage in an artery on the right side of the brain, which causes decreased blood flow to this area. A CVA can be either acute or chronic, and it can affect one or both sides of the brain. A patient like Julie Joseph needs both medical and emotional treatment in order to improve her health.

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