Clinical Decision Making
Pathophysiology: Cerebrovascular Accident (CVA) A cerebral vascular accident (CVA) is defined as “a sudden loss of brain functioning from a disruption of blood supply to a part of the brain causing temporary or permanent loss of movement, thought, memory, speech, or sensation”(Belleza, 2016, p. 1). CVA is categorized as ischemic or hemorrhagic. Hypertension accounts for the majority of ischemic CVAs or strokes. According to the American Heart Association, ischemic strokes are “caused by narrowed or clogged blood vessels in the brain that cut off the blood flow to the brain cells”("Stroke and High Blood Pressure," 2016, p. 1). The following are the main causes of ischemic stroke:
• Thrombosis: An obstruction of a blood vessel leading to localized occlusion. A common cause is atherosclerosis, which can lead to narrowing of the diseased blood vessel. Blood flow may be restricted as platelets adhere to atherosclerotic plaque forming a clot.
• Embolism: A clot or other material that forms within the vascular system, travels from that site, and causes blockage and ischemia in distal vessels. This occurs more commonly in the heart and lungs and can lead to hemorrhagic transformation.
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The physician reviewed the patient’s lab results and inquired about any changes with his erectile dysfunction. Upon examining the patient, the physician observed a slight change in his facial expression. The physician proceeded to teach the FNP student how to perform an accurate neurological exam and what specific signs to look for. The patient was encouraged to delay treatment for erectile dysfunction until the results of the diagnostic test were received. The FNP student reviewed the importance of medication compliance, along with diet modification and exercise. The patient had a better understanding of the complications hypertension and diabetes and how these factors led to his erectile dysfunction and
Pathophysiology: Cerebrovascular Accident (CVA) A cerebral vascular accident (CVA) is defined as “a sudden loss of brain functioning from a disruption of blood supply to a part of the brain causing temporary or permanent loss of movement, thought, memory, speech, or sensation”(Belleza, 2016, p. 1). CVA is categorized as ischemic or hemorrhagic. Hypertension accounts for the majority of ischemic CVAs or strokes. According to the American Heart Association, ischemic strokes are “caused by narrowed or clogged blood vessels in the brain that cut off the blood flow to the brain cells”("Stroke and High Blood Pressure," 2016, p. 1). The following are the main causes of ischemic stroke:
• Thrombosis: An obstruction of a blood vessel leading to localized occlusion. A common cause is atherosclerosis, which can lead to narrowing of the diseased blood vessel. Blood flow may be restricted as platelets adhere to atherosclerotic plaque forming a clot.
• Embolism: A clot or other material that forms within the vascular system, travels from that site, and causes blockage and ischemia in distal vessels. This occurs more commonly in the heart and lungs and can lead to hemorrhagic transformation.
• …show more content…
The physician reviewed the patient’s lab results and inquired about any changes with his erectile dysfunction. Upon examining the patient, the physician observed a slight change in his facial expression. The physician proceeded to teach the FNP student how to perform an accurate neurological exam and what specific signs to look for. The patient was encouraged to delay treatment for erectile dysfunction until the results of the diagnostic test were received. The FNP student reviewed the importance of medication compliance, along with diet modification and exercise. The patient had a better understanding of the complications hypertension and diabetes and how these factors led to his erectile dysfunction and