To teach the students properly, a nurse educator needs to have an in-depth knowledge of the pathophysiologic mechanisms of diseases (to explain to the students how a disease harms the organism), the associated physical assessments (to teach them how to identify/diagnose diseases), and the pharmacologic implications for care (so the students may prescribe the appropriate drugs).
In this paper, we will study the case of Charles Gibson, an imaginary patient who has suffered from an ischemic stroke, and offer recommendations concerning the prescription of medications to him. We will also take a closer look at the role of the nurse educator in the students’ professional development.
Mr. Gibson was diagnosed with an ischemic stroke when he arrived at the hospital. He was treated with the tissue plasmogen activator. Recently, he was moved from the emergency department to the rehabilitation unit. According to the post-stroke MRI, the patient had no worsening ischemia, and had reperfusion in the affected area of the brain.
The patient can consume nectar-thick foods; it is planned to move him to soft diet if swallow evaluation results are good enough. He also has difficulty speaking; the problems appear to have motor origins. Mr. Gibson identifies words when he is shown pictures with items for everyday use.
His current physical assessments are within the normal: the heart rate is 82 with normal sinus rhythm; the blood pressure is 130/80; the respiratory rate is 18, regular (the normal RR for people of Mr. Gibson’s age is 12-28 (Rodríguez-Molinero, Narvaiza, Ruiz, & Gálvez-Barrón, 2013)); the oxygen saturation is 96% on 2 L/min; the body temperature is 98.6 F.
On the whole, the patient’s condition seems to be favorable. He is apparently recuperating from his ischemic stroke.
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There are a number of factors that have predisposed the patient to the ischemic stroke. First, the patient had hypertension before the stroke (and refused to take medications for it); the vessels that are constantly tense can lead to a lack of blood supply, which increases the chance of an ischemic stroke.
Second, diabetes is also a risk factor (Hewitt, Guerra, del Carmen Fernández-Moreno, & Sierra, 2012); high sugar in blood damages many organs, including the vessels: the tunica intima loses its smoothness, which increases the risk of blood clotting. Third, smoking is also a factor that greatly increases the likelihood of a stroke; among the most known mechanisms are hypercoagulability (thrombophilia) and atherosclerosis (fibrofatty plaques inside the vessels) (Edjoc, Reid, Sharma, & Fang, 2013).
Fourth, the patient had the habit of eating all kinds of food, including junk food; apart from being a factor that increases the risk of stroke directly, it also exacerbates the patient’s diabetes. Fifth, the patient is overweight (weight: 250 lbs, height: 6 feet), which also stimulates the formation of plaques in the arteries, thus increasing the likelihood of thrombi, and, consequently, a stroke.
To identify the specified pathophysiological problems that led to the stroke, it is essential to gather information about the patient’s habits, as well as to obtain some clinical data. To know about the patient’s hypertension, it is necessary to monitor his blood pressure regularly for a period of time – to identify the persistently high BP.
To find diabetes, it is important to control the level of sugar in the blood; the blood for the tests must be taken on an empty stomach, because the levels of sugar in blood increase after an intake of food. The rest of the named factors that increase the risk of a stroke are more apparent (because they are related to the lifestyle, such as eating junk food or smoking cigarettes, or because they are rather obvious, such as being overweight).
To identify the pathophysiological problems caused by the ischemic stroke (the lack of blood supply to the brain), it is possible to look at the consequences of the stroke. The LoC (level of consciousness) test can be used not only to identify the severity of stroke; it includes a number of symptoms typical of a stroke, many of which are a loss of a certain function.
Other tests may be used to identify the lost or damaged functions. Finally, a CT or MRI scan can be used to identify the area where the stroke occurred (Ünlüer et al., 2012); this information can be utilized to understand which functions are likely to have been impaired.
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