Patient with Neurological Disorder example

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Patient with Neurological Disorder

A 38-year-old female patient named Jane Doe was rushed to the hospital by ambulance. She came in unconsciousness, unresponsive but breathing. Glasgow Coma scale is 7 out of 15. Vital signs showed TEMP-99 degrees Fahrenheit, HEART RATE-100 bpm, BLOOD PRESSURE-150/80 mmHg, O2 SATURATION-89%, RESPIRATORY RATE-20 bpm. Intubation was done. The patient was admitted to ICU. She is accompanied by her cousin. Past history indicated newly diagnosed hypertension and she is on Carvedilol 25 mg. The patient is also known for using drugs in the past. Patient has been refusing to take medications. Patient experienced severe headache, dizziness, confusion, dysarthria, and paresthesia yesterday but refused to go to the hospital until her daughter comes back from vacation. As per doctor's order, laboratory tests done were Toxicology screen, ABG's, blood glucose, electrolytes, BUN, partial thromboplastin and prothrombin times. Toxicology screen came positive. All others were insignificant. The doctor ordered for CT scan or Computed Tomography, EEG and cerebral angiography. Results were evident of a cerebral aneurysm. Medications ordered were Verapamil 10 mg IV, Mannitol 2 g/kg IV and Labetalol IV infusion 200 mg/160 ml of dextrose 5% water to run at 2mg/min. The doctor gave options for surgical management of hemorrhage: surgical evacuation by craniotomy, endovascular reatment (occlusion of the parent artery) or aneurysm coiling- the obstruction of an aneurysm by a coil (done in specialized neuro-interventional radiology suites). The family of the patient will still discuss the matter.

Patient with Endocrine Disorder

A 62-year-old male patient named John Smith was brought by wife with complaints of hyperthermia, tachycardia, itching, palpitations, persistent sweating, diarrhea, and restlessness. Upon checking, vital signs are TEMP- 103 degrees Fahrenheit, HEART RATE- 135 bpm, RR-23, BLOOD PRESSURE-145/85 mmHg, O2 SATURATION-90% on RA, and PAIN-0. Upon assessment, these things are observed: Patient has flushed salmon-colored dry skin and eyes are exophthalmic. Patient's wife told that her husband had been encountering problems at work, manifesting fine hand tremors and lost weight of about 1.5 kg last month. Patient has a history of Diabetes Mellitus Type 2 on Insulin pen. Laboratory test showed TSH or Thyroid Stimulating Hormone is low 0.2 mIU/L; T3 (triiodothyronine) and T4 (thyroxine) showed above normal values of 300 ng/dL and 13 ug/dL. Patient blood sugar is 140 mg/dl (above normal with no food intake for 4 hours). The doctor advised for exophthalmometry, thyroid scan and CT scan. Exophthalmometry showed 24 mm measurement of the eyes and thyroid scan showed enlargement of the thyroid gland. CT scan confirmed results of thyroid scan. Medical diagnosis is Thyrotoxicosis. Medications ordered are to continue home Insulin medication, Tylenol 650 mg PRN, Tapazole 15 mg/day for 5 days and Synthroid 25 mcg/day for 10 days. The doctor also advised, if relapses occur, radioactive iodine therapy and subtotal thyroidectomy, for which the patient refused.



Hinkle, J. L., & Cheever, K. H. (2013). Brunner & Suddarth's textbook of medical-surgical nursing. Lippincott Williams & Wilkins.

Article in a Scholarly Journal

Teasdale, G., & Jennett, B. (1974). …

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