...factors are classified according to their potential for modification into modifiable and non modifiable risk factors. Some risk factors for stroke we simply can not do anything about. According to the vast majority of literature non modifiable risk factors include; advanced age, previous stroke, heredity, race, and gender. 1. Advanced age: It is widely accepted that stroke increases dramatically with age and it is more likely to affect the elderly. The risk of suffering a stroke roughly doubles for each decade of life after age 55. The majority of strokes occur at 7th decade of life and it rarely occurs at the ages below of 35 years old. 2. Previous stroke: People who have previously suffered a stroke or a “mini stroke” (Transient ischemic attack or TIA) are at higher risk. Survivors of stroke or TIA are at risk of new vascular events. Statistics show that a previous stroke or TIA increases the risk of a future stroke in the next 5 years by 25 to 40 percent. 3. Heredity: Risk is greater if a parent, grandparent or sibling has had a stroke. Family history of both parents may be related to increased stroke risk. Genetic predisposition has been documented in humans and studies have shown that monozygotic twins have a 5- fold increase in stroke incidence compared to dizygotic twins. 4. Race: Higher stroke rates are noted in African Americans, Hispanic Americans and the black race compared to the white one. African Americans have a much higher risk of death from stroke...
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...Determining Diagnosis Code Categories • A 68-year-old male presents to the office complaining of pronounced weakness on the right side of his body and slurred speech for the past 24 hours. Based on the examination, the physician orders an MRI to investigate a possible transient ischemic attack. The physician ordered an MRI to investigate the possibility of a transient ischemic attack. This means that the physician is unsure of the diagnosis. Codes 780-799, used for symptoms, signs and ill-defined conditions, should be used. According to the text, these codes are used for conditions in which a definitive diagnosis cannot be made. If TIA is the diagnosis, I believe it would receive a code between 390-459 (Valerius et al.,2008). • A 44-year-old male presents to the office complaining of intermittent chest pain. The physician orders an EKG to rule out a possible cardiac event. This case, I believe, would also receive a code from 780-799, because of the fact that it states the physician is trying to rule out the "possibility" of a cardiac event. Without further information, that would be my best guess. Now, if the patient were diagnosed with a cardiac event, depending on what it was exactly, it would be coded with a code between 390-459. If the chest pain is not related to a cardiac event, and happens to be related to something in the respiratory system, then it would receive a code from 460-519. Without more information, it is...
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...Determining Diagnosis Code Categories HCR/220 June 7, 2013 Donna DeGrio Determining Diagnosis Code Categories • A 68-year-old male presents to the office complaining of pronounced weakness on the right side of his body and slurred speech for the past 24 hours. Based on the examination, the physician orders an MRI to investigate a possible transient ischemic attack. The physician ordered an MRI to investigate the possibility of a transient ischemic attack. This means that the physician is unsure of the diagnosis. Codes 780-799, used for symptoms, signs and ill-defined conditions, should be used. According to the text, these codes are used for conditions in which a definitive diagnosis cannot be made. If TIA is the diagnosis, I believe it would receive a code between 390-459 (Valerius et al.,2008). • A 44-year-old male presents to the office complaining of intermittent chest pain. The physician orders an EKG to rule out a possible cardiac event. This case, I believe, would also receive a code from 780-799, because of the fact that it states the physician is trying to rule out the "possibility" of a cardiac event. Without further information, that would be my best guess. Now, if the patient were diagnosed with a cardiac event, depending on what it was exactly, it would be coded with a code between 390-459. If the chest pain is not related to a cardiac event, and happens to be related to something in the respiratory system...
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...it can cause brain stem infractions. Although migraines cannot cause permanent damage to the brain. Exercise that causes adrenaline can help make migraines go away. Headaches and migraines can be caused by cerebrovascular accidents. People don’t know what yet exactly causes headaches. It may be caused by nerve cells on the brain. It also can be over stimulated blood vessels, which leads to inflammation. Estrogen and progesterone can cause migraine and headache in women. Migraines can be hereditary and can be passed down. Migraines cannot cause disability to the brain. Scientist says migraines can be neurological disease. Migraines are on one of the most mistreated disease. Women with migraines are seven times more likely to have an ischemic stroke. Migraine can cause a block in an artery which can trigger the...
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...Allergies: Sulfonamides, iodine, iodine contrast dye. Significant Medical History and/or Other Medical Diagnoses Hypertension, Hyperlipidemia, Colon cancer, Uterine cancer, CVA, legally blind, macular degeneration, Ileostomy, renal insufficiency. Current Treatments & Interventions for the Client Anticoagulation therapy, Transfer with 1 person assist, physical therapy consult, occupational therapy consult. Recent Tests & Procedures and the Results CBC: High hematocrit, low platelets, normal WBCs CT Scan of Head: 2 areas of ischemic attacks. EEG: Signs cerebral ischemic attacks parietal and occipital lobes. Assessment Focus Assessment (specify): | Data: Pt. stated she woke up during the night and noticed the right side of her body was weak and she found it difficult to move her right arm and right leg. Pt. brought to the ED where a CT scan was performed. This showed areas of ischemic attacks. Pt. is alert and oriented to place and situation. The patient is aware of time but is unable to give the exact time. May or may not be attributed to her being legally blind. Pupils round equal and reactive bilaterally. Right hand grasp slightly weaker then left. Lungs bilaterally clear and diminished in bases. Bowel sounds active times 4 quadrants. Pt. has ileostomy which is pink, draining watery green and brown stool. Pt. has atrial fibrillation. Heart rate is irregular upon auscultation. Pt. right leg is weaker than left leg. Pt. has decreased ROM and...
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...Picture going about a normal day when suddenly you become dizzy and nauseated. You start to vomit. You try to get to the bathroom but the world feels like it’s tilted and it’s hard to walk. You keep falling to the right as you try to make your way through the house. As you pass by a mirror, you see that your right eyelid is drooping. When trying to drink some water, you struggle with swallowing and your right hand feels numb. These are some of the many symptoms caused by lateral medullary syndrome which is a stroke in the brainstem. Although there are many other types of strokes that are even more debilitating, this particular kind can be hard to diagnose due to the wide range of symptoms that overlap with other illnesses and issues. Lateral medullary syndrome involves an infarct of the posterior inferior cerebellar artery affecting the lateral region of the medulla oblongata. There was a case in which a 49 year old man named Chase W. arrived at his doctor’s office complaining of a sudden onset of the above symptoms along with decreased 2 point discrimination in his right hand and decreased pain and temperature sensation on the right side of his face and left upper extremity. Mr. W had a history of moderate hypertension and smoking but he told his doctor he had quit a year ago because of his high blood pressure. The results of his CT scan came back normal, but the MRI showed that he had a small diagonal lesion in the dorsolateral part of his medulla oblongata and an obstruction...
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...can cause two types of obstruction. One is the Cerebral thrombosis refers to a thrombus (blood clot) that develops at the clogged part of the vessel. The second one is the Cerebral embolism refers to a blood clot that forms at another location in the circulatory system, commonly the heart and large arteries of the upper chest and neck. A portion of the blood clot breaks loose, then enters the bloodstream and travels through the brain's blood vessels until it reaches vessels too small to let it pass. However, a second important cause of embolism is an irregular heartbeat, known as atrial fibrillation. Atrial fibrillation creates conditions where clots can form in the heart, dislodge or force out and travel to the brain which can cause Ischemic...
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...Use of Intravenous Heparin by North American Neurologists Do the Data Matter? Ahmad Al-Sadat, MD; Mohammad Sunbulli, MD; Seemant Chaturvedi, MD Background and Purpose—Our aim was to determine current usage patterns of intravenous heparin for patients with acute ischemic stroke. Methods—A survey was undertaken of 280 neurologists from the United States and 270 neurologists from Canada. Brief vignettes were presented for the following 5 scenarios: stroke in evolution, atrial fibrillation-related stroke (A FIB), vertebrobasilar stroke, carotid territory stroke, and multiple transient ischemic attacks. The effect of medicolegal factors was also ascertained. Statistical comparisons were done with chi-squared testing. Results—US neurologists were significantly more likely than Canadian neurologists to use intravenous heparin for patients with stroke in evolution (51% versus 33%, P0.001), vertebrobasilar stroke (30% versus 8%, P0.001), carotid territory stroke (31% versus 4%, P0.001), and multiple transient ischemic attacks (47% versus 9%, P0.001). The vast majority of US and Canadian neurologists would use intravenous heparin for acute stroke patients with A FIB (88% and 84%, respectively). US neurologists more often cited medicolegal factors as a potential influence on the decision-making process than Canadian neurologists (33% versus 10%, P0.001). Conclusions—In several clinical scenarios, US neurologists were significantly more likely than Canadian neurologists...
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...information to be able to do it. A stroke happens when a blood clot clogs an artery (a blood vessel that carries blood from the heart to the body) or when a blood vessel (a tube that allows blood to flow through out the body) breaks, interrupting blood flow to an area of the brain. When this happens two million brain cells are dying every minute. The longer you stroke without medical attention increases your odds of permanent brain damage, disability, or even death. This is why it is so important to know and understand the symptoms of a stroke. I believe our government could do more to inform our society about the seriousness of a stroke. There are two major different types of strokes. The Ischemic stroke is responsible for 87 percent of all strokes. The Ischemic stroke occurs when your arteries become clogged with blood clots or by the gradual build up of plaque and other fatty deposits. Hemorrhagic strokes occur when a blood vessel breaks in the brain. When this happens, the blood does not make it where it needs to be instead, it fills up in the brain where it shouldn’t be. This type of stroke is only responsible for 13 percent of all strokes, but it is responsible for over 30 percent...
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...damages to the brain can result in death. One comparatively common cause of brain damage and death is referred to as a stroke. Definition A stroke is the sudden death of brain cells in a localized area due to insufficient blood flow. A stroke is very similar to a heart attack, only in this situation; blood flow to brain is blocked rather than blood flow to the heart. Strokes are also called cerebrovascular accidents or “brain attacks” to accentuate the need to call 911 and get immediate medical attention when they occur. Causes A stroke occurs when the blood flow supplied to the brain is interrupted or reduced. This denies your brain of oxygen and nutrients, which can cause your brain cells to die. It may be caused by a blocked artery (Ischemic stroke) or the leaking/bursting of a blood vessel (Hemorrhagic stroke). Some people may experience a temporary disruption of blood flow to their brain, which is called Transient Ischemic attack (TIA). There are two major ways that strokes generally occur: 1. Ischemic stroke: About 85% of strokes are ischemic strokes. Ischemic strokes occur when the arteries going to your brain become narrowed or blocked, causing severe reduction of blood flow (ischemia). The most common ischemic strokes include: • Thrombotic stroke. A thrombotic stroke occurs when a blood clot (thrombus) forms in one of the arteries that supply blood to your brain. A thrombus may be caused by fatty deposits (plaque) that are accumulated up in arteries and cause reduced blood...
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...Family Health Promotion in Nursing Practice February 22, 2014 Family Health Promotion Health promotion is defined as the science and art of helping people improve their lifestyle to move toward a state of optimal health (Edelman & Mandle, 2010). The World Health Organization (WHO) believes health promotion allows health to be a resource and not the objective of living (WHO, 2012). This paper will review the purpose of health promotion as related to nursing practice, and how nursing roles and responsibilities have evolved in regards to health promotion and implementation on the prevention, management and long term maintenance and rehabilitation on Stroke patients, including preventing education to the public and communities, on a primary, secondary, and tertiary prevention level (Edelman & Mandle, 2010). A stroke is caused by the disruption of the blood supply to the brain, usually related to a blood vessel ruptures or blocked by a clot, as define by World Health Organization. The blockage of oxygen and nutrients to the brain’s tissues can cause permanent damage to the brain tissue. Warning signs of stroke are, sudden weakness or numbness of the face, arm or leg, most often on one side of the body. Other symptoms include: confusion, difficulty speaking or understanding speech; difficulty seeing with one or both eyes; walking, dizziness, loss of balance or coordination; severe headache with no known cause; fainting or unconsciousness. The effects of a stroke...
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...Stroke Definition: A stroke is the sudden death of the cells in a specific area of the brain caused by inadequate blood flow. Another name for it is cerebral vascular accident (CVA). A stroke is also called a brain attack. Description: A stroke occurs when an artery bursts or becomes closed when a blood clot lodges in it and blood flow is interrupted to that part of the brain. Blood circulating to that area of the brain served by the artery stops at the point of rupture, and the brain tissue in that area dies or is damaged. The effects of a stroke are determined by which portion of the brain is affected and how much damage occurs. A stroke can cause memory loss, speech impairment, reasoning ability, loss of vision, paralysis, coma, and death, depending on what region of the brain is affected. Strokes are considered to be medical emergencies that require immediate treatment. About one third of strokes can be followed by transient ischemic attacks (mini-strokes). These strokes temporarily interrupt blood flow to the brain and cause similar symptoms like sudden vision loss or temporary weakness in a limb. Quick treatment can improve the chances of survival and increase the degree of recovery. A person who may have suffered a stroke should be seen in a hospital emergency room immediately. To be most effective, blood clot prevention treatment should begin within three hours of a stroke. More than half a million people in the United States experience a new or recurrent stroke...
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...There are three types of strokes that cause changes to the brain: Hemorrhagic stroke,Intracerebral hemorrhage and Transient ischemic attack (TIA). Ischemic stroke is the most common form of stroke, accounting for around 87% of strokes. Strokes are the 5th leading cause of death in the US, with one person dying every 4 minutes as a result. For African Americans, stoke is the 3rd leading cause of death.(http://www.cdc.gov/stroke/facts.htm) It is estimated that About 795,000 people have a stroke each year; about one every 40 seconds - there are many medical conditions that can cause a stroke and it is estimated that 8 out of 10 strokes can be prevented. However, there are some things that cannot be controlled when you are predisposed to stroke; such as your age and race.(http://www.webmd.com/stroke/stroke-causes-risks) A stroke is caused by an interruption of the blood supply to part of the brain, a stroke can happen to anyone - although there are different reasons that put some people at higher risks such as age, family history, high blood pressure, smoking, being overweight, diabetes and high cholesteral.(http://www.stroke.org/understand-stroke/what-stroke) The three types of strokes have specific causes. Ischemic stroke is the most common form of stroke, accounting for around 87% of strokes. This type of stroke is caused by blockages or narrowing of the arteries that provide blood to the brain, resulting in severely reduced blood flow. Hemorrhagic stroke are caused by arteries...
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...A stroke is a type of cardiovascular disease that affects the cerebral arteries, those blood vessels that carry blood to the brain. A stroke occurs when one of those blood vessels in the brain is obstructed or ruptures flooding the brain with blood. Depriving blood and oxygen to the brain results in those immediate cells death, causing the brain not to function properly. Once parts of the brain stop functioning, it can directly affect the areas of the body controlled (1). A stroke can be generally be defined in two types of categories. The first and most common type of stroke is called ischemic stroke. This occurs when a blood clot (cerebral thrombosis) blocks a blood vessel in the brain. Blood flow beyond the blood clot is then restricted, and the part of the brain that relies on that blood supply becomes oxygen deficient and can die (1). A blood clot can develop in a narrowed artery that supplies the brain or can travel directly from the heart (or somewhere in the body) to an artery that supplies the brain. Blood clots are usually the result of other issues in the body that affect the normal blood flow. Common problems that affect the normal blood flow include: hardening of the arteries, irregular heart rhythms, infection of the heart valves, congenital heart defects, blood clotting disorders, inflammation of the blood vessels, etc. (2) The less common but more deadly of the two strokes is called a hemorrhagic stroke. A hemorrhagic stroke occurs when an artery in the brain...
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...what remains unclear to most families is exactly what the condition is and what causes it. To gain better knowledge and understanding of the disease called stroke, one must be familiar with how it is caused, its forms, symptoms, facilitators, how it is diagnosed, treated, and prevented. By definition, a stroke is a condition where a blood clot or ruptured artery or blood vessel blocks the flow of blood to a specific area of the brain. It is a lack of flowing oxygen and glucose to the brain that leads to the deterioration of brain cells and the start of brain damage, thus resulting in the person developing speech impairment, memory, and movement. There are two main categories in which strokes are classified, ischemic stroke and hemorrhagic stroke. The ischemic stroke is what accounts for seventy-five percent of all cases of strokes. In this condition, a blood clot, or thrombus, forms and blocks the flow of blood to the part of the brain where it is needed. Adversely, if a clot should form elsewhere in the body and breaks off to become free-floating, it is then referred to as an embolus. This clot may then be carried throughout the bloodstream and directly to the...
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