Steven Case Study, The Pathophysiology of Steven’s CVA, Pharmacology & Medical History - Nursing Assignment Help

Assignment Task -                 
 

Case Study 

Steven is a 61-year-old man who lives with his wife Marie in suburban Adelaide. Steven is a  Senior Partner in a Law firm and recently reduced his working hours to 30 hours per week,  from 60 hours. 
This morning while eating breakfast, Steven experienced sudden onset slurring of speech,  had facial droop on his left-hand side with weakness in the left side upper and lower limbs. Marie spotted this sudden onset of symptoms and immediately called for an ambulance, which arrived within 15 minutes. 
Steven was taken to ED where on arrival he had a BP of 165/90 mmHg, HR 95, RR 25, SpO2  94% on room air, and a temperature of 37.2. He was diagnosed with an ischaemic CVA. 

Social Hx notes: 
Planning on retirement in 1 - 2 years. 
Lives in a Bungalow with his wife Marie, who is a recently Retired Teacher. 2 Adult  Children, both married with their own children - 1 life close by, the other lives overseas. Lifestyle Changes implemented over the past 2 3 Years following Dx Prediabetes. Outside work he enjoys golf, usually playing at least 2-3 per week. Also enjoys playing  Bridge with Friends. 
Took up walking 3 Years ago following Dx Prediabetes. Walks 5 - 6 days per week for between 30 - 45 mins. 
Ex-Smoker - Hx Smoking 30 Years x 10 - 15/day - Quit 3 Years ago following Dx  Prediabetes. 
Social Beer Drinker 10 - 15 Standard Drinks per week with 3 - 4 per session, although sometimes after Golf may be more. 
Steven is transferred to the neurological ward. On assessment, he is FAST +ve, has left facial droop, left motor weakness (upper limb 0/5, lower limb 2/5), and slurred speech. He is scheduled to see the speech pathologist and the physiotherapist later today. 
 

1.Identify the most likely type and cause of Steve’s CVA 
Your answer must include a rationale for this selection and explain how and why this cause can lead to a CVA from a pathophysiological perspective.

•  Include in your answer the pathophysiology of Steven’s CVA.  
•  In other words, discuss the pathogenesis of the most likely cause and how it can lead to CVA.
• Consider his past medical history.  

2Identify two (2) other risk factors that Steven has for CVA 
 For each of these risk factors explain how & why they can increase the risk of  & lead to CVA. 
3 Select two (2) signs and/or symptoms that Steven had as a result of his CVA  
• For each sign/symptom explain how & why it can occur after a CVA, again from a pathophysiological perspective. 

4. Select three (3) of Steven’s discharge medications and explain why each of the three (3) medications was ordered for Steven 
Your discussion should include the pharmacodynamics and pharmacokinetics of each medication, including relevant adverse effects and contraindications.

5. Each of Steven’s discharge medications is to be administered orally. This means they will all undergo the first-pass effect. Explain what the first pass is and the implications this has for a drug’s bioavailability. 
This assessment focuses on the clinical knowledge and critical thinking you have gained in  the topic and your ability to apply it using critical thinking. You need to demonstrate that you understand the concepts of Pathophysiology and Pharmacology and their effects on the human body.  

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