SAINT MICHAELS COLLEGE OF LAGUNA

School of Nursing and Midwifery

Old National Highway, Platero, Bian Laguna.

Influenza
A Case Study

Submitted by:
Almazan, Nathaniel Paulo B.
Student

Submitted to:
Ms. Edith Vizcarra R.N
Instructor

What is a stroke?
A stroke, previously known medically as a cerebrovascular accident (CVA), is the
rapidly developing loss of brain function(s) due to disturbance in the blood supply to the
brain. This can be due to ischemia (lack of blood flow) caused by blockage (thrombosis,
arterial embolism), or a hemorrhage (leakage of blood). As a result, the affected area of
the brain is unable to function, leading to inability to move one or more limbs on one
side of the body, inability to understand or formulate speech, or an inability to see one
side of the visual field.[2]
A stroke is a medical emergency and can cause permanent neurological damage,
complications, and even death. It is the leading cause of adult disability in the United
States and Europe and it is the number two cause of death worldwide. Risk factors for
stroke include advanced age, hypertension (high blood pressure), previous stroke or
transient ischemic attack (TIA), diabetes, high cholesterol, cigarette smoking and atrial
fibrillation. High blood pressure is the most important modifiable risk factor of stroke.
A stroke is occasionally treated in a hospital with thrombolysis (also known as a "clot
buster"). Post-stroke prevention may involve the administration of antiplatelet drugs
such as aspirin and dipyridamole, control and reduction of hypertension, the use of
statins, and in selected patients with carotid endarterectomy, the use of anticoagulants.
Treatment to recover any lost function is stroke rehabilitation, involving health
professions such as speech and language therapy, physical therapy and occupational
therapy.

Classification
Strokes can be classified into two major categories: ischemic and hemorrhagic.
Ischemic strokes are those that are caused by interruption of the blood supply, while
hemorrhagic strokes are the ones which result from rupture of a blood vessel or an
abnormal vascular structure. About 87% of strokes are caused by ischemia, and the
remainder by hemorrhage. Some hemorrhages develop inside areas of ischemia
("hemorrhagic transformation"). It is unknown how many hemorrhages actually start as
ischemic stroke.

Signs and symptoms

Stroke symptoms typically start suddenly, over seconds to minutes, and in most cases
do not progress further. The symptoms depend on the area of the brain affected. The
more extensive the area of brain affected, the more functions that are likely to be lost.
Some forms of stroke can cause additional symptoms. For example, in intracranial
hemorrhage, the affected area may compress other structures. Most forms of stroke are
not associated with headache, apart from subarachnoid hemorrhage and cerebral
venous thrombosis and occasionally intracerebral hemorrhage.

Anatomy And Physiology Of The Circulatory System

The circulatory system is an organ system that passes nutrients (such as amino acids,
electrolytes and lymph), gases, hormones, blood cells, etc. to and from cells in the body
to help fight diseases and help stabilize body temperature and pH to maintain
homeostasis.
This system may be seen strictly as a blood distribution network, but some consider the
circulatory system as composed of the cardiovascular system, which distributes
blood, and the lymphatic system, which distributes lymph. While humans, as well as
other vertebrates, have a closed cardiovascular system (meaning that the blood never
leaves the network of arteries, veins and capillaries), some invertebrate groups have an
open cardiovascular system. The most primitive animal phyla lack circulatory systems.
The lymphatic system, on the other hand, is an open system.
Two types of fluids move through the circulatory system: blood and lymph. The blood,
heart, and blood vessels form the cardiovascular system. The lymph, lymph nodes, and
lymph vessels form the lymphatic system. The cardiovascular system and the lymphatic
system collectively make up the circulatory system.

The Heart
The heart is a myogenic muscular organ found in all animals with a circulatory system
(including all vertebrates), that is responsible for pumping blood throughout the blood
vessels by repeated, rhythmic contractions. The term cardiac (as in cardiology) means
"related to the heart" and comes from the Greek , kardia, for "heart".
The vertebrate heart is composed of cardiac muscle, which is an involuntary striated
muscle tissue found only in this organ, and connective tissue. The average human
heart, beating at 72 beats per minute, will beat approximately 2.5 billion times during an
average 66 year lifespan, and weighs approximately 250 to 300 grams (9 to 11 oz) in
females and 300 to 350 grams (11 to 12 oz) in males.

The Arteries
Arteries are blood vessels that carry blood away from the heart. This blood is normally
oxygenated, exceptions made for the pulmonary and umbilical arteries.
The circulatory system is extremely important for sustaining life. Its proper functioning is
responsible for the delivery of oxygen and nutrients to all cells, as well as the removal of
carbon dioxide and waste products, maintenance of optimum pH, and the mobility of the
elements, proteins and cells of the immune system. In developed countries, the two
leading causes of death, myocardial infarction and stroke, each may directly result from
an arterial system that has been slowly and progressively compromised by years of
deterioration.

The Capillaries
Capillaries (pronounced /kplri/) are the smallest of a body's blood vessels and are
parts of the microcirculation. They are only 1 cell thick. These microvessels, measuring
5-10 m in diameter, connect arterioles and venules, and enable the exchange of water,
oxygen, carbon dioxide, and many other nutrient and waste chemical substances
between blood and surrounding tissues.

The Aorta
The aorta (pronounced /ert/; from Greek - aort, from - aeir "I lift,
raise") is the largest artery in the body, originating from the left ventricle of the heart and
extending down to the abdomen, where it branches off into two smaller arteries (the
common iliacs). The aorta distributes oxygenated blood to all parts of the body through
the systemic circulation.

Patients Profile:

Name: Pt. X
Age: 62
Gender: Male
Civil Status: Married
Religion: Catholic
Address: Soro Soro Bian, Laguna
AP: Dr. Arnold Mina
CC: Dysphagia

Neurological Examination:
-

Awake
Slurred speech
Responsive
Able to follow commands and simple instructions

Past Medical History

1 day ptc noted difficulty of swallowing, no consultation
Day of admission, condition persists with slurring of speech, consult

(+) smoker
(+) alcoholic drinker
(-) diabetic

NCP

Assessment
Subjective:

Nursing
Diagnosis

Activity
intolerance r/t
Objective:
generalized
Assessment
Received
lying bodyNursing
weakness
Diagnosis
on bed c # 12 D5
0.3
NaCl 500 cc Sleep pattern
Subjective:
@
L
hand disturbance r/t
infusing
well
c slight presence of
Objective:
SD
of D5 lying
LR iL + abdominal spasms
Received
8
amps
on bed c # 12
D5
Diazepam
x
24
0.3 NaCl 500 cc
-@ L hand
c
slurred
speech
infusing well c
-SD
s abdominal
of D5 LR iL +
spasms
8 amps
-Diazepam
s DOB x 24
-- cc muscle
slurred
weakness
speech
-- cs NGT,
patent
abdominal
-spasms
on OF 1,600
Kcal/day
- s DOB for four
equal
feedings
- c muscle
weakness
- c NGT, patent
- on OF 1,600
Kcal/day for four
equal feedings

Planning
within the shift,
promote safety &
comfort measures to
preventPlanning
aspiration
during feeding the pt.
thru
WithinNGT
the shift, the pt. will
be able to sleep

Implementation

Rationale

-established rapport

-To gain pts trust

-monitored v.s.
Implementation

-to see the pts condition

Rationale

-regulated ivf

-to maintain fluid & electrolyte

balance
-To gain pts trust

-established rapport
-o.f.
feedingv.s.
done
-monitored

-to
the pts
pt. his
dietary
-to give
see the
condition
need

-instructed
s.o. to turn pt
-regulated ivf
side to side q2

-to maintain fluid & electrolyte

-to
avoid pressure ulcers and
balance
promote good blood
circulation
-to give the pt. his dietary

-demonstrated
to the s.o.
-o.f. feeding done
how to do the PROM
-instructed
-instructed s.o.
s.o. to
to do
turnPROM
pt
for
the
pt.
side to side q2

need
-to help the s.o. learn how to
perform
PROMulcers and
-to avoidthe
pressure
promote good blood
-for
good blood circulation
circulation

-maintained quiet environment

- promotes relaxation

-instructed pt to maintain
adequate rest periods and sleep

-to promote relaxation

Evaluation
After the shift,
safety and
comfort
Evaluation
measures
were
maintained and
aspiration
After the shift, the
precaution
was
pt. was able to
sleep
estabished

Drug Study
Drug Name
Pletaal 100mg

Indications

Dosage and
Administration

Pletaal is indicated for

the reduction of
symptoms of
intermittent claudication,
as indicated by an
increased walking
distance.

The recommended
dosage of Pletal is 100
mg b.i.d. taken at least
half an hour before or
two hours after
breakfast and dinner. A
dose of 50 mg b.i.d.
should be considered
during coadministration
of such inhibitors of
CYP3A4 as
ketoconazole,
itraconazole,
erythromycin and
diltiazem, and during
coadministration of such
inhibitors of CYP2C19
as omeprazole.
Patients may respond
as early as 2 to 4 weeks
after the initiation of
therapy, but treatment
for up to 12 weeks may
be needed before a
beneficial effect is
experienced.

Side Effects

Contraindications

Body as a whole:
Chills, face edema,
fever, generalized
edema, malaise, neck
rigidity, pelvic pain,
retroperitoneal
haemorrhage.
Cardiovascular: Atrial
fibrillation, atrial flutter,
cerebral infarct, cerebral
ischemia, congestive
heart failure, heart
arrest, haemorrhage,
hypotension, myocardial
infarction, myocardial
ischemia, nodal
arrhythmia, postural
hypotension,
supraventricular
tachycardia, syncope,
varicose vein,
vasodilation, ventricular
extrasystoles,
ventricular tachycardia.
Digestive: Anorexia,
cholelithiasis, colitis,
duodenal ulcer,
duodenitis,

Cilostazol and several of

its metabolites are
inhibitors of
phosphodiesterase III.
Several drugs with this
pharmacologic effect
have caused decreased
survival compared to
placebo in patients with
class III-IV congestive
heart failure. Pletal is
contraindicated in
patients with congestive
heart failure of any
severity.

Drug Name
Celecoxib 200mg

Indications
CELEBREX is indicated
for relief of the signs and
symptoms of pain

Dosage and
Administration

Side Effects

Use lowest effective

dose for the shortest
duration consistent with
treatment goals for the
individual patient.

Gastrointestinal:
Constipation,
diverticulitis, dysphagia,
eructation, esophagitis,
gastritis, gastroenteritis,
gastroesophageal
reflux, hemorrhoids,
hiatal hernia, melena,
dry mouth, stomatitis,
tenesmus, vomiting

Contraindications

NSAIDs, including
CELEBREX, cause an
increased risk of serious
gastrointestinal adverse
events including
These doses can be
bleeding, ulceration, and
given without regard to
perforation of the
timing of meals.
stomach or intestines,
which can be fatal.
These events can occur
Osteoarthritis
Cardiovascular:
at any time during use
Aggravated
and without warning
For relief of the signs
hypertension, angina
symptoms. Elderly
and symptoms of OA
pectoris,
coronary
artery
patients are at greater
the recommended oral
risk for serious
dose is 200 mg per day disorder, myocardial
infarctionGeneral:
gastrointestinal events.
administered as a single
dose or as 100 mg twice Allergy aggravated,
allergic reaction, chest
daily.
pain, cyst NOS, edema
generalized, face
Rheumatoid Arthritis
edema, fatigue, fever,
hot flushes, influenzaFor relief of the signs
like symptoms, pain,
and symptoms of RA
peripheral pain
the recommended oral
dose is 100 to 200 mg
twice daily.

Drug Name
metropolol

Indications
indicated for the
treatment of
hypertension. They may
be used alone or in
combination with other
antihypertensive agents.

Dosage and
Administration
Hypertension
The dosage of
Lopressor tablets
should be
individualized.
Lopressor tablets
should be taken with or
immediately following
meals.
The usual initial dosage
of Lopressor tablets is
100 mg daily in single or
divided doses, whether
used alone or added to
a diuretic. The dosage
may be increased at
weekly (or longer)
intervals until optimum
blood pressure
reduction is achieved. In
general, the maximum
effect of any given
dosage level will be
apparent after 1 week of
therapy.

Side Effects
Central Nervous
System: Tiredness and
dizziness have occurred
in about 10 of 100
patients. Depression
has been reported in
about 5 of 100 patients.
Mental confusion and
short-term memory loss
have been reported.
Headache, nightmares,
and insomnia have also
been reported.
Cardiovascular:
Shortness of breath and
bradycardia have
occurred in
approximately 3 of 100
patients. Cold
extremities; arterial
insufficiency, usually of
the Raynaud type;
palpitations; congestive
heart failure; peripheral
edema

Contraindications

Cardiac Failure:
Sympathetic stimulation
is a vital component
supporting circulatory
function in congestive
heart failure, and beta
blockade carries the
potential hazard of
further depressing
myocardial contractility
and precipitating more
severe failure. In
hypertensive and angina
patients who have
congestive heart failure
controlled by digitalis
and diuretics, Lopressor
should be administered
cautiously.

Research Paper help

https://www.homeworkping.com/