Michelle Case Scenario - Nursing Assignment Help

Assignment Task

Question 1:
While eating breakfast, 62-year-old Michelle experienced sudden onset slurring of speech, had facial droop on her left-hand side with weakness on the left side of her body. Michelle’s husband noticed the sudden onset of symptoms and immediately called for an ambulance, which arrived within 15 mins. Michelle was taken to the emergency department (ED) where she was immediately assessed. The ED doctors determined quickly Michelle had suffered a stroke.
Michelle did not lose consciousness at any point. The following was found on examination (exam findings have been numbered for easy reference in answers).
• EF1: Left facial droop (all muscles of the face affected)
• EF2: Weakness in left upper limb muscles
• EF3: Slurred speech
• EF4: Sensory loss in left face, left upper limb (arm and hand). There is loss of pain and fine touch sense in the face and upper limb.
1. For EACH examination finding, list 2 specific neuroanatomical structures that would cause the examination finding if affected. Do NOT include arteries where a stroke may have occurred in this question – you need to identify specific nervous tissue structure that would explain the finding.
2. Consider the examination findings together and explain which specific artery was involved in Michelle’s stroke. Your answer should show your understanding of vascular territories and justify why Michelle didn’t experience weakness/sensory loss in all areas of her body.
3. Given Michelle’s symptoms and examination findings – do you think she has experienced ischaemic stroke or hemorrhagic stroke? Briefly justify your answer.

Question 2:
Callum was an academically gifted and confident young man but as he entered his late teens, he seemed to lose focus and could not control his emotions; he had difficulty concentrating at school, had issues completing school projects and sticking to a study plan. In his final year of school, he fell behind in his schoolwork and received a very low year 12 score. He also lost his part time job at Woolworths due to ongoing poor performance including being rude to a customer.
Callum spent much of the following year staying in his room and relying on alcohol to moderate his feelings. At the start of Spring he vanished from the family house for two weeks and when he returned home he seemed to have an inability to express where he had been or how he felt. He would not eat food prepared by his mother, voicing concern that it might be poisoned, and spent a lot of time conversing to himself.
Unfortunately, Callum’s family has experienced similar challenges as Callum’s uncle had displayed similar behaviours and was diagnosed as schizophrenic.
1. Discuss Callum’s decrease in cognitive functioning and behavioural changes and explain which components of higher order/executive functions are likely to be affected in Callum.
You need to explain your reasoning and propose possible anatomical changes in Callum’s brain.
2. Addiction and schizophrenia seem to be a part of Callum’s condition. Describe the geneenvironment concepts of these two conditions and the anatomical changes that occur in the brain.

Question 3:
Sally is a 16-year-old high school student that plays footy for both her school and local club. She trains 4 times a week and plays 2 games over the weekend. Two weeks ago, she was playing an early morning game in particularly cold weather. In the opening moments of the game an opposing player rammed her knee into Sally’s thigh. At the time, the pain was intense, rated as an 8/10. She was pulled off the field and the sports trainer encouraged her to rub her thigh to reduce the intensity of the pain.
1. Using your knowledge of receptors in the skin, elaborate on the differing nerve endings in cutaneous tissue (skin) that are likely to transmit the stimuli (an opposing player ramming her knee into Sally’s thigh).
2. Describe the anatomical and physiological properties/characteristics of the axons that transmit the noxious stimuli and where synapse occurs in the spinal cord. (Hint: try to be specific).
3. Explain the mechanism and neurological basis behind rubbing of the area providing pain relief.

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