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Mr. Chen is an 86-year-old male who was admitted to the ICU after suffering an acute...

Mr. Chen is an 86-year-old male who was admitted to the ICU after suffering an acute cerebrovascular accident (stroke). He has been on bedrest for several weeks due to his critical condition. Mr. Chen has now been transferred to the neurology unit for continued care. Mr. Chen is on an antihypertensive medication to manage his hypertension. He has a right sided weakness as a result of his stoke but is weight bearing Today is the first day that Mr. Chen is scheduled to be out of bed.

a)Explain 3 patient assessment factors that the nurse should consider prior to getting Mr. Chen out of bed.

b)Explain 2 safety risk factors the nurse should consider when implementing the transfer for Mr. Chen.

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Answer #1

Answer1.

a.Impaired physical mobility related to hemiparesis, loss of balance and coordination, spasticity, and brain injury.

b.Risk for skin integrity related to hemiparesis or hemiplegia and decreased mobility.

c.Disturb sensory perception related to altered sensory reception, transmission, and/or integration.

Answer2.

  • Large artery thrombosis. Large artery thromboses are caused by atherosclerotic plaques in the large blood vessels of the brain.
  • Small penetrating artery thrombosis.Small penetrating artery thrombosis affects one or more vessels and is the most common type of ischemic stroke.
  • Cardiogenic emboli. Cardiogenic emboli are associated with cardiac dysrhythmias, usually atrial fibrillation.
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