Background: • Don Dixon is a 65-year-old

Background: • Don Dixon is a 65-year-old male admitted the day before in the early morning for ischemic stroke to the left Middle Cerebral Artery (MCA) anterior branch infarct. Patient was found by his wife in the morning unable to get out of bed, with weakness to the upper/lower extremities, unable to state his name, with garbled speech, and disoriented. He was last seen normal the evening before at 9:30 pm when he went to bed. She called 911 and patient was brought to ER by ambulance. Assessment: • Vital Signs: T:98.7; HR: 100; RR: 28; BP:190/100; SpO2: 96% RA • General Appearance: Well-groomed male who appears stated age. • Cardiovascular: Normal Sinus with audible S1 and S2. No murmurs • Respiratory: Breath sounds clear • GI: Normoactive bowel sounds • GU: Clear, yellow • Extremities: Right arm and leg weakness • Skin: Warm, dry and pale • Neurological: Alert and oriented to person. Pupils equal, round and reactive to light and accommodation. • IVs: Saline lock • Labs: None ordered • Fall Risk: High-risk • Pain: 0/10 Physician’s Orders: 1. Admit to Medical Surgical Unit 2. Diagnosis: R/O TIA 3. Full Code 4. Diet as Tolerated 5. May be out of bed with continuous supervision 6. Saline lock 7. Bathroom privileges 8. Metoprolol 25 mg PO daily 9. Aspirin 81 mg PO daily 10. Multi-Vitamin PO daily 11. Albuterol Inhaler 2 puffs prn shortness of breath 12. Call if O2 sat drops below 96% Preparation Questions: 1. What are the signs and symptoms of swallowing difficulty? 2. What are some of the nursing diagnoses that might be appropriate for swallowing difficulties? 3. What are some of the appropriate nursing interventions? 4. What screening tools can be used to diagnose swallowing deficits? 5. Identify members of an interdisciplinary team in caring for the patient with swallowing deficits? 6. What are the complications associated with swallowing deficits? 7. What teaching will the nurse implement to prevent or reduce the incidence of aspiration? 8. What are the signs and symptoms of TIA? 9. Describe the pathophysiology of TIA. 10. What are the goals of medical treatment for the patient with TIA? 11. What are some of the appropriate nursing interventions? 12. What are the steps of a neuro assessment related to TIA? SCIENCE HEALTH SCIENCE NURSING NURS NURS676A

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