13.23 Clinical Judgment: Case Study
A 68-year-old client went for a walk with a friend, then went grocery shopping to buy food to make dinner. The client and their partner made dinner. While eating dinner, the client’s partner noticed the client staring into the distance, not responding to their name. Within a few seconds, the client tried to respond and their speech was slurred, with the right side of their cheek and mouth drooping. The client tried to stand up but was unable to use their right arm to support them.
The client’s partner called 911 immediately. The ambulance arrived within 15 minutes and began interventions according to the signs of stroke. The client received the stroke medication Alteplase (used to dissolve a clot) shortly after being admitted to the unit.
The client is now at day 3 on the stroke unit. The client has a medical history of breast cancer at 49 years old, diagnosed with hypertension and high cholesterol two years ago, and is taking medication. The client has a history of smoking, but quit a year and a half ago. The client lives with their partner in a two-story house and retired last year. The client does not have children. The client has a younger brother, who has a partner, and a nephew who lives in the same city. The client enjoys walking and swimming.
As a result of the stroke, the client has dysphagia, right facial droop, dysarthria, and right-sided paresis. After a week in the hospital, the client was transferred to a stroke center, has mild expressive aphasia, and is progressing well.
