CVA-Stroke
Option: CT (noncontrast), a moderate intracerebral bleed, 3mm of shift, and mass effect.
The non-contrast CT findings of a moderate intracerebral bleed, 3mm shift, and mass effect suggest Intracerebral hemorrhage (ICH). ICH refers to primary, spontaneous, non-traumatic bleeding in the brain parenchyma. The initial assessment will include measuring vital signs and a general physical examination. The National Institutes of Health Stroke Scale (NIHSS) score will be used to assess the neurological baseline severity score (Madangarli et al., 2019). The GCS will be applied to evaluate the patient’s level of consciousness.
Diagnostic orders will include a complete blood count (CBC), electrolytes, creatinine level, blood glucose, and coagulation studies.
Pharmacological interventions will aim at blood pressure management if the patient has an elevated BP. This will include administering short half-life antihypertensives with labetalol or nicardipine to avoid overshoot hypotension. If the patient is on anticoagulants like Warfarin, it will be discontinued, and he will be administered 10 mg of Vitamin K IV (McGurgan et al., 2019). Patients with ICH often cannot protect the airway because of reduced consciousness. Endotracheal intubation may be performed, but this intervention will be balanced against the risk of losing the neurologic examination (Madangarli et al., 2019). Pretreatment with lidocaine is recommended to blunt a rise in intracranial pressure (ICP) associated with intubation.
The anticipated clinical manifestations in this client include a decreased level of consciousness, headache, vomiting, seizures, and very high BP. The patient may also have a GCS score of 13 and below. Patients diagnosed with ICH should be admitted to a dedicated stroke or neuroscience intensive care unit. Thus, the plan will be to refer the patient to the stroke center for neurological consult and stroke management (McGurgan et al., 2019). Management of patients with ICH in a dedicated stroke unit is linked to decreased mortality and better functional outcomes than management in a general neurology ward.
References
Madangarli, N., Bonsack, F., Dasari, R., & Sukumari–Ramesh, S. (2019). Intracerebral hemorrhage: blood components and neurotoxicity. Brain sciences, 9(11), 316. https://doi.org/10.3390/brainsci9110316
McGurgan, I. J., Ziai, W. C., Werring, D. J., Al-Shahi Salman, R., & Parry-Jones, A. R. (2020). Acute intracerebral haemorrhage: diagnosis and management. Practical neurology, 21(2), 128–136. Advance online publication. https://doi.org/10.1136/practneurol-2020-002763
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Topic 6: Evaluating Practice Change
Topic 8: Evidence-Based Practice Appraisal
Topic 5: Communicating for Effective Change
Contemporary Organization Evaluation
Develop the Integrated Testing Plan
Topic 7: Aligning Staffing Models and Budgets
What type of staff performance indicators would you monitor to ensure you were meeting your budget? How would you monitor these indicators?
Topic 1: Differentiating Quality Improvement, Evidence-Based Practice, And Research
Your unit data reflect an upward trend in blood administration errors
Describe at least two limitations to both primary and secondary data and how understanding those limitations can improve your future CQI work
What is the difference between primary and secondary data?
Choose the two elements that you feel are the most difficult to achieve and provide one strategy for each that will make them achievable.
What two elements do you believe play the most significant role in sustaining change and why?
Topic 1 DQ 1: Society for Human Resource Management
It is important to ensure that a candidate fits into the culture of the organization.
What formal and informal onboarding or assimilation processes exist in your organization or an organization with which you are familiar?
What do you think is most necessary for learning to occur in your current organization?
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Important information for writing discussion questions and participation
Welcome to class
Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to
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Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.
Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.
I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!
Hi Class,
Please read through the following information on writing a Discussion question response and participation posts.
Contact me if you have any questions.
Important information on Writing a Discussion Question
- Your response needs to be a minimum of 150 words (not including your list of references)
- There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
- Include in-text citations in your response
- Do not include quotes—instead summarize and paraphrase the information
- Follow APA-7th edition
- Points will be deducted if the above is not followed
Participation –replies to your classmates or instructor
- A minimum of 6 responses per week, on at least 3 days of the week.
- Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
- Each response needs to be at least 75 words in length (does not include your list of references)
- Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
- Follow APA 7th edition
- Points will be deducted if the above is not followed
- Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
- Here are some helpful links
- Student paper example
- Citing Sources
- The Writing Center is a great resource