Case Study For Hypertension And Smoking Assignment

Case Study For Hypertension And Smoking Assignment

In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factored in the diagnosis and explain the implications to patient health.

74-year-old male with a history of hypertension and smoking, is having dinner with his wife when he develops sudden onset of difficulty speaking, with drooling from the left side of his mouth, and weakness in his left hand. His wife asks him if he is all right and the patient denies any difficulty. His symptoms progress over the next 10 minutes until he cannot lift his arm and has trouble standing. The patient continues to deny any problems. The wife sits the man in a chair and calls 911. The EMS squad arrives within 5 minutes. Upon arrival in the ED, patient ‘s blood pressure was 178/94, pulse 78 and regular, PaO2 97% on room air. Neuro exam – Cranial nerves- Mild left facial droop. Motor- Right arm and leg extremity with 5/5 strength. Left arm cannot resist gravity, left leg with mild drift. Sensation intact. Neglect- Mild neglect to left side of body. Language- Expressive and receptive language intact. Mild to moderate dysarthria. Able to protect airway Case Study For Hypertension And Smoking Assignment.

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To prepare:
Assignment (1- to 2-page case study analysis) Provide at least 3 primary references; a classroom textbook, 2 peer-reviewed journals would be very supportive of points.
Keep citations and references in APA format. No patient ed links, Mayo, Cleveland clinic, no Medscape.
In your Case Study Analysis related to the scenario provided, explain the following:
Both the neurological and musculoskeletal pathophysiologic processes that would account for the patient presenting these symptoms.
Any racial/ethnic variables that may impact physiological functioning.
How these processes interact to affect the patient. Case Study For Hypertension And Smoking Assignment

Case Study

Musculoskeletal and Pathophysiological Symptom Analysis

In this case, smoking and hypertension predispose the patient to developing ischemic stroke. According to research, the toxic substances in cigarette smoke activate the immune system when introduced into the body. During smoking, the body undergoes oxidative stress characterized by the production of reactive oxygen species in the endothelial cells, which contribute to the destruction and dysfunction of the endothelium. For example, long-term exposure to cigarette smoke may hurt the endothelial wall’s elasticity. Moreover, cigarette smoking may also interfere with the calcium ion signaling channels that mediate smooth muscle contraction and relaxation. In response to these physiological changes, the body activates cytokines and other pro-inflammatory molecules, which promote the adherence of macrophages to the endothelial cells of blood vessels. Notably, the increased secretion of CC cytokine during smoking promotes the overexpression of monocyte chemoattractant protein that binds to monocytes resulting in blood vessel inflammation. Monocytes differentiate into macrophages which ingest oxidized low-density lipoproteins (LDL) present in the blood to form fatty streaks that accumulate in the endothelia, narrowing it and increasing the risk for hypertension. Narrowed blood vessels may reduce or obstruct blood flow to the brain. The oxygen-deprived cells die, resulting in sudden loss paralysis, difficulty in speaking, and weakness, as observed in this Case Study For Hypertension And Smoking Assignment.

Diagnostic Factors

During diagnosis, the health professionals will consider the symptoms. In this case, the patient presented with a sudden onset of neurologic symptoms such as left side paralysis, characterized by drooling on the left side, difficulty speaking, and weakness in the left arm. Within a few minutes, the symptoms progressed quickly, and the patient could no longer lift his left arm or stand. According to Morrow et al. (2019), health professionals use the acronym FAST in stroke diagnosis, which represents facial droop, arm drop, speech impairment, and time Case Study For Hypertension And Smoking Assignment.

After symptom identification, health professionals take the vital signs to assess breathing, circulation, and airway patency. In this case, the blood pressure, pulse, and PaO2 were measured. Although the pulse rate was regular at 78 beats per minute, the patient had stage two hypertension measured 178/94, consistent with research and clinical observations of stroke pathophysiology (Singh et al., 2017). The final diagnostic consideration before ordering imaging tests is the physical examination which allows health professionals to estimate the extent of brain damage. In this case, the health professionals conducted a neurological examination revealing intact sensation, mild dysarthria, facial droop, left-side weakness, and the left arm’s inability to resist the pull of gravity. The patient could understand and respond to speech and could control the right side of the body.

Implications of Cultural Variables

The seventy-four-year-old patient may need to adjust cultural and lifestyle beliefs and practices while managing the disease. Since smoking is a significant risk factor for the disease, health professionals will advise him to stop the practice. Withdrawal from smoking may affect the patient’s mood as the drug’s calming effect helps him cope with challenging situations.

During dinner with his wife, the patient denies being unwell, indicating he is afraid of showing his weaknesses. Since the illness has caused paralysis in the patient’s left side of the body, he will be unable to function independently. He might depend on his wife to perform nearly all tasks. This loss of independence may unsettle the patients so much that they may fall into depression Case Study For Hypertension And Smoking Assignment.

References

Morrow, A., Miller, C. B., & Dombrowski, S. U. (2019). Can people apply ‘FAST’ when it really matters? A qualitative study guided by the common sense self-regulation model. BMC public health, 19(1), 643. https://doi.org/10.1186/s12889-019-7032-6

Musuka, T. D., Wilton, S. B., Traboulsi, M., & Hill, M. D. (2015). Diagnosis and management of acute ischemic stroke: speed is critical. CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne, 187(12), 887–893. https://doi.org/10.1503/cmaj.140355

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Singh, S., Shankar, R., & Singh, G. P. (2017). Prevalence and Associated Risk Factors of Hypertension: A Cross-Sectional Study in Urban Varanasi. International journal of hypertension, 2017, 5491838. https://doi.org/10.1155/2017/5491838

Wang, W., Zhao, T., Geng, K., Yuan, G., Chen, Y., & Xu, Y. (2021). Smoking and the Pathophysiology of Peripheral Artery Disease. Frontiers in Cardiovascular Medicine, 8. https://doi.org/10.3389/fcvm.2021.704106 Case Study For Hypertension And Smoking Assignment