NURS 6501 Neurologic and Musculoskeletal Pathophysiologic Processes Paper
NURS 6501 Neurologic and Musculoskeletal Pathophysiologic Processes Paper
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. NURS 6501 Neurologic and Musculoskeletal Pathophysiologic Processes Paper
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Case –
A 72-year-old woman is brought to the clinic by her daughter. The daughter reports that her mother had an acute onset of slurred speech that morning, but it resolved within an hour. About an hour later she noted her mother was a lethargic and speechless. When she attempted to get her mother to stand, she panicked when her mother slumped over to the right side and couldn’t seem to push herself to an upright position or stand. The daughter reports that her mother had a stroke 2 years ago and exhibited similar symptoms resulting in a 5-day hospital stay followed by intensive rehabilitation where she was able to return to normal functioning. When you see the patient, she is alert, ambulating, and has 4/5 strength bilaterally in the upper and lower extremities. DTRs are 2+ bilaterally. A CT of the head reveals an old left sided infarct within the temporal region. A CT of the carotids reveals a 35% blockage on the left and 40% on the right. Blood pressure is 134/84, P 84, and respirations 18. Labs tests reveal a cholesterol of 306, HDL of 36, and an LDL of 140. NURS 6501 Neurologic and Musculoskeletal Pathophysiologic Processes Paper
Ischaemic stroke results from either embolic or thrombotic events that lead to a decrease in blood flow to the brain. The Na+/K+ ATPase pumps fail due to the poor production of adenosine triphosphate and failure of the aerobic mechanism (Hui et al., 2022). In embolic cases, debris from elsewhere in the body obstructs blood flow through the affected vessel. The most common source of the clot is; chambers or valves of the heart. Other causes include; air, fat, venous or septic emboli. On the other hand, a thrombotic event, blood flow is blocked within the blood vessel secondary to dysfunction within the vessel itself such as arterial dissection, inflammatory condition and atherosclerotic disease (Meschia & Brott, 2017). The clinical presentation depends on the particular area of reduced blood flow.
Racial/ethnic variables that impact physiologic functioning
The prevalence of stroke and death rates from the disease are increased among African Americans than any other racial group. According to the American Heart Association, African Americans are at a greater risk of stroke and more severe strokes than whites (Howard et al., 2019)NURS 6501 Neurologic and Musculoskeletal Pathophysiologic Processes Paper. The ethnic discrepancy is associated with some of the risk factors in African Americans such as; biological differences and lower socioeconomic status in African Americans compared with whites.
How the processes interact to affect the patient
African Americans people often have an increased risk of stroke due to predisposing factors such as; diabetes, elevated blood pressure, high cholesterol levels, obesity and smoking (Boehme et al., 2017). Lower social economic status is associated with a reduced likelihood for receiving the necessary treatment intervention (Albright et al., 2018)NURS 6501 Neurologic and Musculoskeletal Pathophysiologic Processes Paper. Access to health care services is a leading cause of racial disparities.
References
Albright, K. C., Huang, L., Blackburn, J., Howard, G., Mullen, M., Bittner, V., Muntner, P., & Howard, V. (2018). Racial differences in recurrent ischemic stroke risk and recurrent stroke case fatality. Neurology, 91(19), e1741–e1750. https://doi.org/10.1212/wnl.0000000000006467
Boehme, A. K., Esenwa, C., & Elkind, M. S. V. (2017). Stroke Risk Factors, Genetics, and Prevention. Circulation Research, 120(3), 472–495. https://doi.org/10.1161/circresaha.116.308398
Howard, V. J., Madsen, T. E., Kleindorfer, D. O., Judd, S. E., Rhodes, J. D., Soliman, E. Z., Kissela, B. M., Safford, M. M., Moy, C. S., McClure, L. A., Howard, G., & Cushman, M. (2019). Sex and Race Differences in the Association of Incident Ischemic Stroke With Risk Factors. JAMA Neurology, 76(2), 179. https://doi.org/10.1001/jamaneurol.2018.3862
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Hui, C., Prasanna Tadi, & Patti, L. (2022, May). Ischemic Stroke. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK499997/
Meschia, J. F., & Brott, T. (2017). Ischaemic stroke. European Journal of Neurology, 25(1), 35–40. https://doi.org/10.1111/ene.13409 NURS 6501 Neurologic and Musculoskeletal Pathophysiologic Processes Paper