Disorders of the Central Nervous System

Disorders of the Central Nervous System

Peer Responses:

Response 1

Hello, your post provides a clear and concise overview of the immediate steps a nurse should take when suspecting a cerebrovascular accident (CVA). The inclusion of the FAST (Face, Arms, Speech, Time) method as a quick assessment tool is particularly valuable for its simplicity and effectiveness in identifying stroke symptoms (Morrow et al., 2019). Further, the emphasis on assessing the key signs and managing patient anxieties stands taller than the great aspect of total patient care in emergencies.

In addition, one area that could need further clarification is the role of patient history in the initial assessment. Including information about the patient’s medical background, such as any previous strokes or cardiovascular issues, can offer a more comprehensive understanding of their current condition. Further, the details about the primary concern may be sufficient, adding to it a discussion on the subsequent actions, which may include running a number of diagnostic imaging tests, as well as the initiation of certain therapeutic protocols, would be more encompassing of stroke management (Lip et al., 2022). In sum, your post is concise and illustrates the essential first responder interventions for suspected CVA cases.

References

Lip, G. Y. H., Lane, D. A., Lenarczyk, R., Boriani, G., Doehner, W., Benjamin, L. A., Fisher, M., Lowe, D., Sacco, R. L., Schnabel, R., Watkins, C., Ntaios, G., & Potpara, T. (2022). Integrated care for optimizing the management of stroke and associated heart disease: A position paper of the European Society of Cardiology Council on Stroke. European Heart Journal, 43(26), 2442–2460. https://doi.org/10.1093/eurheartj/ehac245

Morrow, A., Miller, C. B., & Dombrowski, S. U. (2019). Can people apply “FAST” when it really matters? A qualitative study guided by the common-sense self-regulation model. BMC Public Health, 19(1). https://doi.org/10.1186/s12889-019-7032-6

Response 2

Hello, your detailed explanation of the assessment process for a client suspected of having a cerebrovascular accident (CVA) is thorough and informative. The emphasis on obtaining a quick history and conducting a comprehensive physical examination is critical in understanding the patient’s condition and tailoring the appropriate response. The process of diagnosis is made more accurate and quicker by the employment of uniform measures such as the Glasgow Coma Scale (GCS), NIH Stroke Scale (NIHSS), and the Cincinnati Prehospital Stroke Scale (CPSS) (Bodien et al., 2021).

Additionally, the post could be strengthened by elaborating on the initial nursing interventions following the assessment. For instance, discussing the immediate steps a nurse should take upon identifying stroke symptoms, such as ensuring airway management, positioning the patient to prevent aspiration, and preparing for potential thrombolytic therapy, would provide a more holistic view of acute stroke management (Green et al., 2021). Evaluating the contribution of emergency medical services and the role of neurologists in stroke management, as well as incorporating the significance of teamwork across disciplines, could enhance the discussion post in more depth. Still, the post shows a comprehensive understanding of the vital pillars of stroke evaluation and initial care.

References

Bodien, Y. G., Barra, A., Temkin, N. R., Barber, J., Foreman, B., Vassar, M., Robertson, C., Taylor, S. R., Markowitz, A. J., Manley, G. T., Giacino, J. T., Edlow, B. L., Badjatia, N., Duhaime, A.-C., Ferguson, A. R., Gaudette PhD, E., Gopinath, S., Keene, C. D., McCrea, M., & Merchant, R. (2021). Diagnosing level of consciousness: The limits of the Glasgow Coma Scale Total Score. Journal of Neurotrauma, 38(23), 3295–3305. https://doi.org/10.1089/neu.2021.0199

Green, T. L., McNair, N. D., Hinkle, J. L., Middleton, S., Miller, E. T., Perrin, S., Power, M., Southerland, A. M., & Summers, D. V. (2021). Care of the patient with acute ischemic stroke (posthyperacute and prehospital discharge): Update to 2009 comprehensive nursing care scientific statement: A scientific statement from the American Heart Association. Stroke, 52(5). https://doi.org/10.1161/str.0000000000000357

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Disorders of the Central Nervous System

Peer Responses:

• Reply to the two students’ posts on Disorder of the central nervous system

STUDENT 1

A cerebrovascular accident (CVA), commonly known as a stroke, is a medical emergency where the blood flow to a part of the brain is suddenly interrupted or reduced, causing brain cells to die (Ignatavicius et al., 2020). When a nurse suspects a client is having a stroke, they will assess and ask the person to smile and check for facial drooping; ask them to raise both arms and see if one drifts downward; ask them to repeat a simple sentence to check for slurred or strange speech; and call emergency services immediately if any signs are present (Duke Health, 2021). Additionally, the nurse checks for sudden numbness, confusion, vision trouble, dizziness, or a severe headache, monitors vital signs, and stays with the patient to keep them calm until help arrives.

Disorders of the Central Nervous System

STUDENT 2

To assess a client suspected to have gone through a cerebrovascular accident (CVA), it is important to ask for a quick history and then conduct a thorough physical examination. Establishing the exact time of when the symptoms started and recording the nature as well as the progression of symptoms is critical. A detailed medical history, which includes prior strokes, transient ischemic attacks, cardiovascular diseases, hypertension, diabetes, and drugs taken, such as anticoagulants, should be sought. While assessing consciousness level using the Glasgow Coma Scale (GCS), cranial nerves would be evaluated for any signs like facial droop, visual disturbance, or speech problems that arise. Assessment should also include checking for unilateral weakness or paralysis, sensory loss, and coordination problems (Budinčević et al., 2022).

In this procedure, neurological assessments are vital. A numerical index of stroke-related neurologic deficits is the NIH Stroke Scale (NIHSS), which contains measures of consciousness, gaze, visual fields, facial palsy, motor function, ataxia, sensory function, language, and speech. The Cincinnati Prehospital Stroke Scale (CPSS) demonstrates symptoms such as facial droop, arm drift, and abnormal speech for rapid assessments in prehospital settings. They include diagnostic tests such as non-contrast CT scan for ischemic or hemorrhagic stroke differentiation and MRI for acceptable imaging (Budinčević et al., 2022).

Acute stroke management emphasizes quick and accurate assessment, which is evidence-based practice. Early diagnosis and treatment results show that using standardized evaluation tools like NIHSS have been shown to enhance significantly. According to Dos Santos et al. (2023), standardized stroke care pathways incorporating these assessments can decrease delays in care provision and enhance recovery rates. Optimum nursing care for patients with strokes will therefore require nurses who are well skilled in these areas of assessments; combining fast.