CASE STUDY

Case Study

Case Study: Diagnosis and Assessment of Stroke

Introduction

Stroke is the primary cause of disability worldwide; the second most common cause of acquired disability; the leading cause of death and has a significant impact on mobility and depression (Carod, 2000). A stroke is similar to a heart attack, only in this case, blood flow to brain, rather than the heart, is blocked (Rice, 2004).

Effective rehabilitation can enhance the recovery process (Coyne, Mares, 2003) and minimize the functional disability (Duncan, Zorowitz, Bates, Choi, Glasbert, Graham, Katz, Lamberty, Recker, 2005). Interventions like psycho-social behavioral interventions (Amarshi. F, Artero. L, Reid. D, 2006; Anderson. C, Hackett. M, House. A, 2004) plus antidepressants may improve depression (Astrom, Asplun, Astom, 1992) and help heal the “Anxiety of Lostness” (Redfield, 1999).

Only 30% of stroke units audited in 2008 have access to a clinical psychologist (National Sentinel Audit, 2008). Psychologist benefits e.g. counseling and spiritual advice (Glass, Matchar, Belyea, Feussner, 1993) can be seen in a useful briefing paper (Psychological Services for Stroke Survivors and their Families, 2005). Stroke nurses are given several opportunities to develop themselves in their fields of interest by undertaking various courses and learning programs at a number of institutions and organizations. These organizations include the National Clinical Guidelines (RCP, 2004), the Stroke Association (U.K) and the World Stroke Organization (Karnia-Lachname, Best, McDonah, Ghosh, 2006). Through these programs, the stroke nurse is able to connect to various experts who provide important learning mechanisms for her professional development. The Leeds Metropolitan University is a special regard to this case, that allows the stroke nurse to attend various courses related to the field of stroke nursing (Sackett, Rosenberg, Gray, Haye, Richard, 1996). In this case study, the author will demonstrate her clinical skills and professional tools in her assessment and re-assessment of the post ischemic stroke survivor (DOH, 2006/07). Mary (subject of our case study) experienced right hemiparesis, dysphasia, dysphasia, homonymous hemianopia with signs of depression. The names have been changed to keep the stroke survivors and their families' details confidential. There are few instances in which stroke prevention did not result in an effective treatment regime. However, timely diagnosis and assessment can cause severe positive effects on the recovery of patients with strokes. Case History

Mrs Mary Murphy was 82 years of age and was presenting Dysphasia and right hemiparesis. This lady was a United Kingdom (UK) resident and was visiting her daughter (Aine) in Ireland. She was tired after her journey and went to bed at 14.15 hours. Mary was found in bed by her daughter at 14.45 hours. Aine rang the Para-medics (National Stroke Strategy, 2007) immediately as she recognized the FAST symptoms from the television advertisement. Subsequently Mary was admitted to hyper-acute stroke unit. The Para-medics contacted the stroke specialist on route after using the FAST tool (Harbison et al, 2003). FAST is an acronym to define the four major symptoms of Stroke including Facial Paralysis, Arm weakness and Speech Difficulties (Perry and Love, ...