Below is a summary of Maya’s EHR activity during her four hours in the ED. As her ED physician, you are responsible for examining Maya, ordering tests and procedures and diagnosing her condition. Using her EHR, Virtual Physical Exam (VPE) and Internet research, answer the questions and be prepared to discuss the responses with the rest of Maya’s healthcare team.
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. After reviewing her NIHSS score in VPE, which areas are of moderate and high concern?
Internet Research: There are three types of strokes. Your first task is to determine what type of stroke Maya is having.
What are the three types of strokes? Provide a brief description of each.
Which is the most common?
Why is it critical for you to determine the correct one?
Internet Research: You write orders for an immediate CT scan of Maya’s brain as well as an angiography. Both of these tests provide different information that may be helpful in determining Maya’s diagnosis. Explain what information each of the procedures will provide in diagnosing a stroke.
Review Maya’s ED EHR: What do the results of Maya’s CT Scan with Angiography indicate?
Internet Research: You determine that Maya is having an ischemic stroke and you will provide her an intravenous injection (IV) of tissue plasminogen activator (tPA). Why?