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Discuss characteristic findings for a stroke and how it affects the lives of patients and their families.

Responses to Peers

Discussion responses to class mates. 2 responses everyday so it has to be 6 responses in 3 days. references required.

Erin Quin

1 – Alzheimer’s is the most common type of dementia. Dementia is a decline in cognitive abilities caused by damage due to trauma, stroke, Alzheimer’s disease, or similar permanent conditions (Falkner & Green, 2018). Over time, dementia results from a decline in daily life’s basic activities, personality and mood changes, social impairment, neuropsychiatric issues, and impaired reasoning (Kontos, Grigorovich, & Colobong, 2020). Alzheimer’s is a progressive disease that gradually worsens over several years with initially mild memory loss symptoms. According to Bonfili et al. (2020), the disease’s key molecular hallmarks are the extracellular amyloid-beta plaques and the intraneuronal neurofibrillary tangles. In the late stages, the individual loses their capacity to respond to others or their environment and ultimately leads to death. The three stages of Alzheimer’s disease are mild, moderate, and severe.

According to Bonfili et al. (2020), gut microbiota can alter normal brain function between the central nervous system and the GI tract in recent studies. This new research plays a role in preventing or counteracting the progression of Alzheimer’s disease. Research already shows certain protein markers that suggest Alzheimer’s disease; what is interesting is the increased permeability of the blood-brain barrier due to gut microbiota. This gut flora causes the penetration of the product to the brain. At this time, there is no prevention, reversal, or cure for Alzheimer’s disease; early diagnosis may allow patients and their families time to prepare for future changes.

Health promotion incorporates lifestyle improvement and modifications, healthy dietary habits throughout the individual’s lifespan. The modifiable risk factors are to manage smoking cessation, continue to start an exercise routine, manage blood pressure, diabetes, dyslipidemia, and postmenopausal hormone replacement therapy (Falkner & Green, 2018). Physical exercise and interventions address modifiable risk factors and impairments and delay functional decline as it directly benefits brain cells and increases blood flow to the brain (McGough, E., Kirk-Sanchez, N., & Liu-Ambrose, T. (2017). Other support to decrease risk factors would be support such as welfare services, public and private agencies, voluntary organizations, family caregivers, and relatives to help with ADLs once progression had declined. Other health promotion or activities needed depending on the disease stage would be; appropriate living arrangements and mental health promotion to reduce insecurity, stress, and anxiety.

References:

Bonfili, L., Cecarini, V., Gogoi, O., Gong, C., Cuccioloni, M., Angeletti, M., … Eleuteri, A. M. (2020). Microbiota modulation as preventative and therapeutic approach in Alzheimer’s disease. The FEBS Journal. DOI:10.1111/febs.15571

Falkner & Green (2018). Pathophysiology: Clinical applications for client health. Retrieved from https://lc.gcumedia.com/nrs410v/pathophysiology-clinical-applications-for-client-health/v1.1/

McGough, E., Kirk-Sanchez, N., & Liu-Ambrose, T. (2017). Integrating health promotion into physical therapy practice to improve brain health and prevent Alzheimer disease. Journal of Neurologic Physical Therapy41, S55-S62. DOI:10.1097/npt.0000000000000181

Pia Kontos, Alisa Grigorovich, & Romeo Colobong. (2020). Towards a critical understanding of creativity and dementia: new directions for practice change. International Practice Development Journal10(Suppl), 1–13. https://doi-org.lopes.idm.oclc.org/10.19043/ipdj.10Suppl.003

Sample – The affects of Alzheimer’s Dementia on the family structure are significant. It is more than the family’s ability to offer physical help to the loved one, it is also emotional, social, and financial support. The disease is no longer considered a geriatric condition therefore families may have to adopt to a new way of living for many years to come. The study I read included 3 stages that families experienced when a loved is diagnosed with Alzheimer’s. Stage one is “what’s going on here”, the second stage is “our life is changing”, and the third stage is “keeping things together”. Families in the study were found to be unified in the care of their loved ones. Positive views of the future instead of dwelling on the present helped them accept the diagnosis. As per our study material this week treatment is supportive for the patient and their caregiver because there is no cure for Alzheimer’s.

Falkner, A. and Green, S. GCU. (2020). Neurological, Perceptual, and Cognitive Complexities. Retrieved from https://lc.gcumedia.com/nrs410v/pathophysiology-clinical-applications-for-client-health/v1.1/#/chapter/2

Nuria Esandi, BSc, MSc, PhD, RN, Mike Nolan, BEd, MA, MSc, PhD RGN, RMN, Cristina Alfaro, BSc, MSc, RN, Ana Canga-Armayor, BSc, MSc, PhD, RN, Keeping Things in Balance: Family Experiences of Living With Alzheimer’s Disease, The Gerontologist, Volume 58, Issue 2, April 2018, Pages e56–e67, https://doi.org/10.1093/geront/gnx084

Sample – I would like to add that people in the mild stages of Alzheimer’s will begin wandering and may loose track of where they are. The person will start to become more disoriented about the date and time of day it is. Some people may loose their ability to remember who they are, where they live, phone number and pieces of their history.

References:

Falkner, A., & Green, S. Z. (2018). Neurological, Perceptual and Cognitive Complexities. In (Ed.), Pathophysiology clinical applications and clinical health(1.1 ed.). Grand Canyon University. https://lc.gcumedia.com/nrs410v/pathophysiology-clinical-applications-for-client-health/v1.1/#/chapter/2

Pree joy

2 – Dementia is a condition in which cognitive abilities are impaired due to the destruction of the cerebral hemisphere, memory, and learning functions in the subcortical portion. The causative factors could be a stroke, trauma, or an irreversible condition such as Alzheimer’s disease. Memory disorders and changes in personality will reveal this condition. 60 to 80% of dementia caused by Alzheimer’s (Porth, 2014). The first phase of Alzheimer’s starts with very minimal memory loss increases gradually finally resulting in a complete inability to perform all his activities and respond to anybody leading to death. According to the CDC (2017a), the sixth leading cause of death in the United States is due to Alzheimer’s. Head injury, hypertension, genetics, obesity, older age, sedentary lifestyle, smoking, type 2 diabetes are the risk factors of AD (Ulep et al., 2017). Signs and symptoms are mood swings such as depression, confusion, unable to concentrate, language problems like difficulty to get the words, memory impairment, risk of wandering, sleep pattern changes, behavioral changes, incontinence, communication problems, difficulty in doing physical activities even to drink or eat, etc. Genetic factors also can contribute to Alzheimer’s disease. Primary prevention includes making the brain active with reading, proper diet, physical activity, adequate sleep, cognitive training These will help to reduce the risk of developing this disease (Harvard Health Publishing, 2017 b). Secondary prevention includes controlling blood pressure, diabetes, weight reduction, smoking, eating Mediterranean and DASH diet, etc. etc. Promoting the quality of life and helping the patient to do physical function is the main intervention for AD since this is not reversible. Supportive and palliative care is mainly given to patients. Maintaining the nutritional status of the patient with careful hand feeding, spiritual and psychological support, achieving the maximum level of cognitive and physical function, keeping them with other patients with cognitive impairment, contact the Alzheimer’s association are health promotions.

Reference

Falkner A, and Green Sue. Z(2018) Neurological, Perceptual, and Cognitive Complexities retrieved from https://www.gcumedia.com/digital-resources/grand-canyon-university/2018/pathophysiology_clinical-applications-for-client-health_1e.php

Lillian Odemba

3 – Alzheimer’s disease is a form of dementia. Dimentia is a progressive degenerative disease that affects brain cell leading to decline in memory and other mental functions. Risk factors for Alzheimer’s are age, genetics, obesity, smoking, sedentary lifestyle,diabetes,head injury and high blood pressure.

According to Falkner & Green (2018) The average life span after diagnosis is eight years with Alzheimer’s being the sixth leading cause of death in the United States , there are three stages of disease progression,Mild, moderate and severe. Mild is the early stage of AD manifesting in word finding difficulties, forgetting a name of someone after being introduced, trouble performing tasks in social or work settings. Moderate Alzheimer’s include becoming lost, unable to remember their address, phone number or where they graduated, confusion of what day it is or where they are, trouble controlling bowel and bladder. Severe Alzheimer’s which is late stage patients become vulnerable to infections, physical abilities decline such as walking and swallowing, difficulty with communicating, lose awareness of the surroundings and need 24-hour supervision, care and performance of ADL’s.

There is no cure for AD therefore, Primary prevention of modifiable risk factors like smoking cessation , balanced diet, physical activity and exercise,prevention of head injuries for example use of helmets while ridding bikes. early diagnosis and treatment of symptoms may delay the progression and decline in function.

Health promotion focuses on improving quality of life,lifestyle modifications , safety and prevention of complications. Assessing for pain,discomfort, elimination needs since they may be unable to verbalize them.

Involving and collaborating family members and other welfare agencies may reduce anxiety, stress and improve memory for the patient and prevention of role strain to caregivers, through resources like The Family Caregiver Alliance.(Falkner & Green 2018).

Balanced nutrition is an important aspect in the care of AD, snacks high in protein for immunity and finger foods are recommended so that the patient can feed themselves,assessing swallowing to prevent complications like chocking and aspiration for those who have trouble swallowing or no longer is able to feed themselves (Falkner & Green, 2018).

References

Falkner, A, Green, S. (2018). Neurological, Perceptual, and Cognitive Complexities. Pathophysiology: Clinical Applications for Client Health. Retrieved from https://www.gcumedia.com/digital-resources/grand-canyon-university/2018/pathophysiology_clinical-applications-for-client-health_1e.php

Erin Quin

4.2 – Discuss characteristic findings for a stroke and how it affects the lives of patients and their families. Discuss the nurse’s role in supporting the patient’s psychological and emotional needs. Provide an example. Consider and discuss the different types of strokes and areas of the brain impacted in your answers.

There are two different types of strokes and two different types of brain attacks. The two types of strokes are ischemic (thrombus) stroke, hemorrhagic stroke. The two brain attacks are cerebrovascular accident (CVA) or Transient ischemic attack (TIA). Strokes happen when poor blood flow to an area of the brain occurs, and the brain cells begin to die due to the lack of oxygen. Hemorrhagic strokes are due to a bleed in the brain, either intracerebral or subarachnoid, while ischemic strokes occur anywhere in the brain a clot can travel through the brain’s blood vessels until it reaches vessels too small to let it pass (American Stroke Association, 2020). In the study by Erkabu et al. (2018), the areas of the brain assessed for stroke, (36.6%) patients the cerebral cortex was affected, and (28.7%) patients had lesions in multiple parts of the brain (lobar, basal ganglia, thalamus, and ventricular involvement). Hemorrhagic stroke accounts for 15% of all strokes and ischemic strokes 40% (Yang, Zhao, & Xu, 2017). According to Falkner & Green (2018), the sudden signs and symptoms of stroke include:

  • numbness or weakness in the face, arm, or leg, especially on one side of the body;
  • confusion, trouble speaking, or difficulty understanding speech;
  • trouble seeing in one or both eyes;
  • trouble walking, dizziness, loss of balance, or lack of coordination; and
  • severe headache with no known cause

When patients have a stroke, their lives and their families’ lives are forever changed due to the negative outcomes. These negative outcomes can burden the family for the care needed and financial responsibilities to accommodate the patient lifestyle changes. Patients and their families will need to reformulate their perception of the new role after a stroke. The nurse can offer support, support groups, counseling, as well as listen when needed, offer encouragement, and watch for signs and symptoms of distress (Falkner & Green, 2018). While showing signs of respect and dignity, the nurse must consider cultural, religious, and spiritual beliefs (Falkner & Green, 2018).

An example of this would be for the nurse to notice the signs of depression in the patient and provide the encouragement and support needed not to give up. The nurse would also recommend a support group or counseling for the patient and family. According to the Americal Stroke Association, their website offers support groups and locations at https://www.stroke.org/en/help-and-support/support-you-are-not-alone/support-group-leader-resources/finding-support-groups.

References:

American Stroke Association. (2020). Finding stroke support groups. Retrieved October 27, 2020, from https://www.stroke.org/en/help-and-support/support-you-are-not-alone/support-group-leader-resources/finding-support-groups

Erkabu, S. G., Agedie, Y., Mihretu, D. D., Semere, A., & Alemu, Y. M. (2018). Ischemic and hemorrhagic stroke in Bahir Dar, Ethiopia: a retrospective hospital-based study. Journal of Stroke and Cerebrovascular Diseases27(6), 1533-1538.

Falkner & Green (2018). Pathophysiology: Clinical applications for client health. Retrieved from https://lc.gcumedia.com/nrs410v/pathophysiology-clinical-applications-for-client-health/v1.1/#/home

Yang, F., Zhao, J., & Xu, H. (2017). Characteristics of Hemorrhagic Stroke following Spine and Joint Surgeries. BioMed Research International2017, 1–5. https://login.lopes.idm.oclc.org/login?qurl=https://doi.org%2f10.1155%2f2017%2f5390839

 

 

Subject: Nursing

 

 

i need 2 responses today and references required. 200-250 words.

 

then 2 by next day and in the mean time i will share another 2 posts. that needs to be finished by saturday. Basically 2 post responses on 3 different days making total of 6

 

Answer preview………………………….

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