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Julie Wilson Case Study CVA

1. The case study involves Julie Wilson who is being assessed for a potential cerebral vascular accident (CVA). Abnormal findings that support the diagnosis of CVA include left-sided weakness, slurred speech, and facial droop. 2. The priority nursing diagnosis is impaired physical mobility related to left-sided weakness from the CVA. 3. The physician has ordered Alteplase and Digoxin. The student will first implement the Alteplase order to break up the clot causing the CVA, administering a bolus of 0.9 mg/kg at a rate of 0.03 mg/kg/min with the goal of restoring blood flow and neurological function.

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164 views2 pages

Julie Wilson Case Study CVA

1. The case study involves Julie Wilson who is being assessed for a potential cerebral vascular accident (CVA). Abnormal findings that support the diagnosis of CVA include left-sided weakness, slurred speech, and facial droop. 2. The priority nursing diagnosis is impaired physical mobility related to left-sided weakness from the CVA. 3. The physician has ordered Alteplase and Digoxin. The student will first implement the Alteplase order to break up the clot causing the CVA, administering a bolus of 0.9 mg/kg at a rate of 0.03 mg/kg/min with the goal of restoring blood flow and neurological function.

Uploaded by

tommy
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Fresno City College

RN-62A Skills Scenario

Case Study and Medication Math for Julie Wilson – CVA

Name: ____________________________ Date:____________ Skills Instructor:_____________________

You may work in small groups and use reference books of your choice
Every student will turn in a separate case study

ASSESSMENT Answer

1. What is the priority assessment/how will you


proceed in your assessment of Julie Wilson?
1pt

2. List at least 3 abnormal assessment findings which 1.


would support the diagnosis of Cerebral Vascular
Accident (these may be physical assessment 2.
findings or subjective complaints)
2pts 3.

3. Of the potential abnormal assessment findings you


listed which one would concern you the most?
Explain why?
1pt
DIAGNOSIS
1. What is your highest priority nursing diagnosis for
Julie Wilson?
1pt
PLANNING
1. Look at the physician’s orders (those given during
the scenario) for Julie Wilson. Which order will you
implement first? Include your rationale. 1pt
2. What co-morbidities or complications would
change your plan for implementing orders?
1pt
Calculate medications for Julie Wilson:
3. The recommended treatment dose of Alteplase is
0.9mg/kg (not to exceed total treatment dose of 90
mg). What is the treatment dose for Julie? 1pt
4. How much will you give as the initial bolus? At
what rate will you give it? 1pt
5. Correlate the therapeutic effect of Alteplase to
treat CVA. 1pt
6. Order: Digoxin 250 mcg po qd. The label reads 1
tablet equals 0.25 mg. How many tablets do you
plan to administer? 1pt
7. Correlate the therapeutic effect of Digoxin/lanoxin
to treat atrial fibrillation 1pt

Page | 1
Fresno City College
RN-62A Skills Scenario
Case Study and Medication Math for Julie Wilson – CVA

IMPLEMENTATION
8. What teaching will you provide to Julie Wilson
regarding proper administration of her
medications? (Activase and Digoxin)
1pt

9. List 3 lab results you are monitoring 1.


1pt
2.

3.

10. Explain the pathophysiologic connection between 1.


the labs you listed and Acute CVA.
2pts 2.

3.

EVALUATION
11. List 3 potential side effects/adverse reactions of 1.
Alteplase for which you will be watching.
2pts 2.

3.

12. List 3 potential side effects/adverse reactions of 1.


Digoxin for which you will be watching.
1pt 2.

3.

13. List one potential complication which would require


you to call the physician. What orders would you
anticipate? 1pt

Page | 2

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