Principles and Practice of Adult Health Nursing

Question: Discuss about the Principles and Practice of Adult Health Nursing. Answer: Introduction: In this paper, the focus will be on Mrs. Amari an old lady with the problem of slurring speech and whose face was dropping on one side. Interpret Mrs. Amari, who is a 59 year old lady currently suffers from hypertension, as well as hypercholesterolemia and is brought to the hospital. Mrs. Amari is a New Zealand Maori lady born in Auckland, New Zealand but later came to Australia to work on a construction site for her family in her teens. Additionally, Mrs. Amari is married to an Australian man, Peter, 26 years who together they have two daughters living in a different state. The lady also has a history of tobacco consumption which went on for 25 years, but she quit 10 years ago. Her husband however still consumes it, and her family has tested positive for heart disease. The patient is also known to take walks once in a while with the neighbors, although she does not have a regular exercise routine. Patient Situation On diagnosing Mrs. Amaris vital signs, the doctors find that her temperature is 36.7Oc which is within the normal range for adults of 35.8OC-37.5Oc. Her blood pressure, on the other hand was at 148/97, the pulse was 81, and she had a respiratory rate of 14, spO2 at 94%, Glasgow coma scale of 15 and the blood glucose was at a level of 6.6mmol. Whereas most of her measurements were within the normal range, her blood pressure exceeded the normal range of below 120/80 mm Hg (Geyer, Gomez, 2009). This could have resulted from lack of exercise, as well as smoking. Other symptoms experienced by Mrs. Amari include numbness which is felt on right area of her face which runs down to the right arm. When she smiles, her mouth diverts to the right side, and she also has a facial droop. She is, however, in a position to move all the extremities, follows the commands, and also has a clear speech. Her pupils are also reactive to light. She is, however, not experiencing weakness, and is also in a position to swallow without difficulties. Her right hand is, however, weaker than the left. According to these symptoms, one can conclude that she is suffering from Transient ischemic attack (TIA). This is according to the symptoms of a patient suffering from TIA which include: "Weakness, numbness, paralysis of the arm, leg, face, or any one side of the body" (Gosney, Harper, Conroy, 2012). They also include a "slurred speech, blindness or double vision, as well as dizziness or loss of balance" (Johnson, Griffin, McArthur, 2006). One can however conclude that a patient is suffering from TIA after the symptoms persist for 24 hours. After 24 hours, Mrs. Amari went through some tests, and her temperature was at 36.8O C, her blood pressure was 175/98, a pulse of 90, respiratory rate of 13, spO2 at 92%, and a blood glucose level of 6.6mmol. Her speech was also slurred, and her mouth had dropped Collect Cues/ Information The complaints which Mrs. Amari had on reporting to the hospital which include slurring speech and face dropping could be related to the disease in question. This is because the concern raised by the doctor of suffering from TIA could actually be correct. The contributing factors are all listed, and the condition remains relevant even after 24 hours (Johnson, Griffin, McArthur, 2006). Where the patient suffers from these symptoms for over 24 hours, the disease is identified as TIA. As such, Mrs. Amaris condition. She is also at a higher risk because she is already suffering from hypertension, as well as hypercholesterolemia which worsen the condition. Hypertension has been established as the most significant modifiable risk for TIA, as well as stroke (Becker, Spencer, 2010). The possibility of TIA, therefore, is heightened in a case where the patient had suffered from hypertension, as well as hypercholesterolemia. It is, however, important to seek further information in order to de termine whether Mrs. Amari was really suffering from TIA. Process Information There are some points which are considered as risk factors for TIA. Mrs. Amari, for instance possesses some of these factors. They include family history, which is positive for heart diseases. One is at a higher risk of catching the disease where their family has had TIA or a stroke (Beare, Myers, 2000). Mrs. Amaris age is also another risk factor, as the disease is prevalent on people who are above the age of 55. It is also identified that she used to smoke for 25 years, and only quit ten years ago. This is one of the major causes of TIA. Further, her husband still smokes, and this could affect her since the two live together. The patient is also not involved in exercise, and only takes some walks once in a while. All these factors could contribute to the disease, and they all point to the possibility of Mrs. Amari suffering from TIA. Some of these factors, therefore, are indications of the risk of Mrs. Amari of suffering from stroke. To avoid the occurrence of stroke in the future , she has to consider engaging in activities that reduce these risks (Singh, Brigham and Women's Hospital, 2014). These activities include establishing a routine where she will engage in active exercise. Additionally, she should advise her husband to quit smoking, so as to avoid inhaling the tobacco. Further, she should seek the attention of a doctor regularly so as to have checkups that are aimed at ensuring her health is okay. TIA should be taken as a warning sign that one is at a risk of suffering from stroke, and should be treated with urgency. Further investigations on the health history of the patient, as well as other factors are important to establish the level of the condition. Additionally, it is important to note the condition of the patient for some time so as to be sure of the presence of this disease. It is also vital for the doctor to find the fundamental cause of the disease, so as to avoid future occurrence of the illness (Stroke foundation, 2016). This is also important in ensuring that he patient does not suffer from stroke. In Mrs. Amaris case, for instance, the risk of stroke occurrence is high. This is due to the presence of the risk factors which include lack of exercise and tobacco smoking in earlier years. As such, the doctors should not only treat all the symptoms thoroughly, but also advice her on the risk factors and how to change them in the future. There are, however, some facto rs which are beyond her control. These include age, the family history, as well as the fact that she suffers from hypertension and hypercholesterolemia Beard, Loftus, Gaines, 2014). A bruit is a sound heard over an artery which is abnormal, and may indicate turbulent blood flow. This may be a concern for a doctor because it may be an indication for blockage of the artery. Infer Mrs. Amaris symptoms clearly indicate that she is suffering from TIA. The symptoms, which include numbness, slurred speech, dizziness, as well as weakness of the hand, show the presence of the illness. This is also confirmed by other risk factors. Other than all the symptoms indicating that she is suffering from the disease, the risk factors confirm the fears. These factors are the causes for the high blood pressure which is by far higher than the normal adult temperatures. The factors include smoking, lack of exercise, as well as the family health history. Additionally, she is suffering from hypertension and hypercholesterolemia. These diseases, therefore, worsen her heart condition, leading to the occurrence of the disease. Bibliography Becker, R. C., Spencer, F. A. (2010). Antithrombotic therapy in the prevention of ischemic stroke.https://search.ebscohost.com/login.aspx?direct=truescope=sitedb=nlebkdb=nl abkAN=669957. Beare, P. G., Myers, J. L. (2000). Principles and practice of adult health nursing. St. Louis: Mosby. Beard, J. D., Loftus, I., Gaines, P. A. (2014). Vascular and endovascular surgery. Edinburgh: Saunders Elsevier. Gosney, M., Harper, A., Conroy, S. (2012). Oxford desk reference. Geyer, J. D., Gomez, C. R. (2009). Stroke: A practical approach. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams and Wilkins Johnson, R. T., Griffin, J. W., McArthur, J. C. (2006). Current therapy in neurologic disease. St. Louis, Mo: Elsevier Mosby Singh, A. Loscalzo, J., Brigham and Women's Hospital,. (2014). The Brigham intensive review of internal medicine. Stroke foundation. (2016). Types of Stroke. Retrieved from: https://strokefoundation.com.au/About-Stroke/Types-of-stroke