Below is a summary of Maya’s electronic health record during her four hours in the emergency room. As her ED physician, you are responsible for examining Maya and ordering tests. These tests will help diagnose her condition. Answer the following questions and be prepared to discuss the responses with the rest of Maya’s healthcare team.

  1. Review Maya’s VPE: You assess Maya’s condition and review her vitals listed in her EHR. Maya’s blood pressure and pulse rate are high, and you are concerned that Maya is having a stroke. You immediately begin performing the National Institute of Health’s Stroke Scale (NIHSS). Maya’s results show her score as a 24, which indicates that she has suffered a severe stroke.

  2. After reviewing her NIHSS score in VPE, which areas are of high concern?
    A. LOC question: Month and age.
    B. LOC question: Open and close eyes
    C. 600 ingredients with 73 known cancer-causing compounds
    D. 500 ingredients with 104 known cancer-causing compounds

  3. Internet Research: There are three types of strokes. Your first task is to determine what type of stroke Maya is having.
      Match the name of the stroke with the correct description.
      ____ Ischemic (clots)       A. A weakened blood vessel ruptures.
      ____ Hemorrhagic (speech)       B. A temporary clot.
      ____ Transient Ischemic Attack       C. An obstruction within a blood vessel.

    1. Of the three types of strokes, which is the most common type of stroke?
      A. Transient Ischemic Attack (TIA)
      B. Hemorrhagic stroke
      C. Ischemic stroke
      D. Both B and C

      True or False: Treatment of all types of strokes use tPA which dissolves the clot and improves blood flow.

  4. Internet Research: You write orders for an immediate CT Angiography of Maya’s brain.
    1. What information can be obtained from a CT Angiography that may be helpful in determining Maya’s diagnosis?
      A. Determine if there is insufficient blood flow to the heart.
      B. Determine if there is blockage of the brain’s blood vessels.
      C. Determine if there is blockage of the carotid arteries.

  5. Review Maya’s ED EHR: What do the results of Maya’s CT Angiography indicate?
    A. Slurred, unrecognizable speech.
    B. Loss of mobility in both right arm and leg.
    C. Diffused region of hypodensity, left ventricle.
    D. All the above

  6. Internet Research: You determine Maya is having an ischemic stroke. Which is the BEST treatment for her?
    A. Cardiovascular procedure
    B. Surgical treatment
    C. tPA injection
    D. Both A and B

  7. View Maya’s EHR – ED Chart   Virtual Physical Exam