NUR241 - Health Alterations - Mrs. Sadie Mangle Case Study - Health Assignment Help

Assignment Task

Clinical Scenario 1 (for Group A nursing students)
Identification Mrs Sadie Mangle, 82 year old, retiree.
Situation Mrs Mangle found in collapsed in the front yard by neighbours Scott & Charlene at 8:30am. She had weakness in the right arm and leg, facial droop and was “talking nonsense”. The patient is admitted to the Medical Ward with an ischaemic CVA.

Background Allergies: penicillin

Medication: Metformin, actrapid, atorvastatin, ACE inhibitors
Past illnesses: T2DM, hypercholesterolaemia, hypertension
Last meal: Dinner the previous night.
Events leading up to presentation: recent episodes of abnormal sensation that resolved within the hour.

SpO2: 95% RA (room air)
HR: 95, strong pulse
BP: 200/110
T: 35
GCS: 14 (confused to time, place, person)
BGL: 10 mmol/L
Cap. Refill Time: 2 seconds, flushed face
CT: ischaemic stroke

Other information
When Mrs Mangle was found she was in her pyjamas without her dressing gown. This is unusual as normally she is up and dressed, walking with Alby at 6am. Alby was inside the house calling out to Sadie. It is suspected that Mrs Mangle collapsed during the night while letting her dog, Bouncer, go to the toilet.
Mrs Mangle is now bed bound due to weakness in the right side (failed on bed mobility test). Mrs Mangle is unable to change positions in bed. The physiotherapy review is pending. Mrs Mangle requires a modified diet due to delayed swallow (assessed by a speech pathologist this morning). The patient is exhibiting “word salad” where the patient is selecting incorrect words.
The patient has not been incontinent, but has a pad in place for now. Mrs Mangle has a normal western diet low in fibre, high in fats and carbohydrates, moderate alcohol intake, but she does not smoke. Normally she sleeps little and is usually independent with ADLs. Mrs Mangle and her husband Alby chief recreation is walking and
gossiping with neighbours.
Mr Mangle lost his license for medical reasons (partial blindness), they both live on the pension and have minimal savings. They own their own home, this is a high set building with 12 steps to the front door. You have been told that Mike, from next door is dropping in to keep an eye on Alby every day. Mrs Mangle seems frustrated in her
attempts to communicate, she is often found crying.

Recommendations - Complete a secondary assessment of the patient including investigations and link the findings to the pathophysiology.

Select, justify and describe two (2) interventions and describe the nursing actions required to implement and evaluate them.

Select and describe nursing actions to prepare the patient for discharge utilising the social justice framework to address the social determinants of health (SDH) that impede the access to, and participation in healthcare.

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