Ms1 - Ct Scan

It is early morning and the client, an 80-year-old woman, is getting out of bed. She has a mild headache over the right temple, is fatigued, and feels slightly weak. She calls for her husband to let him know she will be going back to bed for a while. When her husband comes in to check on her, he finds that she is having trouble saying words and has a slight left-sided facial droop. When he helps her up from the bedside, he notices weakness in her left hand and convinces her to go to the local emergency room.

Her first CT scan was negative for cerebrovascular accident; however, the second CT scan (18 hours later) reveals a small CVA in the right hemisphere. She is still experiencing expressive aphasia, left facial droop, left-sided hemiparesis, and what is presumed to be symptoms of mild dysphagia. Her past medical history includes paroxysmal atrial fibrillation, hypertension, hyperlipidemia, and a remote history of deep vein thrombosis. A recent cardiac stress test was normal, and her blood pressure has been well controlled. She admits to being under recent stress with the death of her husband's adult son. She is hospitalized for 4 days and discharged with orders for outpatient rehabilitation for speech and physical therapy. Medications she took before the CVA were flecainide (Tambocor), hormone replacement therapy, amlodipine (Norvasc), aspirin, simvastatin (Zocor), and trandolapril (Mavik). She is discharged on flecainide, amlodipine, clopidogrel (Plavix), aspirin, simvastatin, and trandolapril.

-Most common cause of CVA is a result from thrombosis. Other causes include

embolism and hemorrhage. Risk factors increase the likelihood of CVA, such as

atherosclerosis, dysrhythmias, rheumatic heart disease, diabetes mellitus,

gout, postural hypotension, and cardiac hypertrophy. Other risk factors include high

serum triglyceride levels, and sedentary life - style ( inactive habit ), the use of

contraceptives, cigarette smoking, and a family history of CVA.

It depends on the severity of your stroke and related complications. While some stroke survivors recover quickly, most stroke survivors need some form of stroke rehabilitation long term, possibly months or years, after their stroke. Your stroke rehabilitation plan will change during your recovery as you relearn skills and your needs change. The length of each stroke rehabilitation therapy session varies depending on your recovery, severity of your symptoms and responsiveness to therapy.

Clopidogrel is used to reduce future atherosclerotic events (stroke) in patients with a recent stroke. The drug's mechanism is it blocks the adenosine phosphate (ADP) receptors, which prevents fibrinogen binding to the receptor.