Tia Case Study Essay

823 Words Jul 22nd, 2013 4 Pages
NURSING DIAGNOSIS
Ineffective tissue perfusion / Altered cerebral tissue perfusion
Risk for injury: Stroke
Impaired verbal communication r/t ischemic injury

NURSING DIAGNOSIS
Ineffective tissue perfusion / Altered cerebral tissue perfusion
Risk for injury: Stroke
Impaired verbal communication r/t ischemic injury

NURSING INTERVENTIONS
Careful monitoring of neurological status (Glasgow come scale, LOC, pupillary responses, extremity movement and strength, facial symmetry, speech and vital signs). Decrease in LOC may indicate increased ICP.
Tube feedings and IV fluids r/t dysphagia. F/C r/t incontinence, pt is placed on B&B training program.
Preventing contractures, building muscle tone with ROM activities, controlling
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Stool softeners, bisacodyl, laxatives.
Bed rest is usually recommended, however some physicians believe early ambulation is best.
Fluids may be restricted for the first few days in an effort to prevent edema of the brain (IV fluids or NG tube)
Surgical interventions to increase blood flow to brain: carotid endarterectomy (CEA) or percutaneous transluminal angioplasty and stenting
Reduction of other risk factors: DM, BP, HLP and smoking cessation
DIAGNOSTIC TESTS
After a TIA the HCP orders a complete workup to rule out carotid artery stenosis.
Noncontrast CT is the primary test used to diagnose a stroke
However, TIA <3 hours old may not show on a CT scan. In this case, the patient will qualify for fibrinolytic therapy.
Others: cerebral angiography, carotid angiography, oculoplethysmography, Doppler ultrasound, Pro time (if anticoag tx is considered), MRI, transesophageal echocardiography

DIAGNOSTIC TESTS
After a TIA the HCP orders a complete workup to rule out carotid artery stenosis.
Noncontrast CT is the primary test used to diagnose a stroke
However, TIA <3 hours old may not show on a CT scan. In this case, the patient will

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