** please response to each peers DQ answers with a comment add citations and references ***** response one: Stroke is the “leading cause of disability in the United Sates†(Faulkner, A. & Green, S., 2018). In 2010, my mother called me at work to report that my father was having trouble speaking, his gait was unsteady and he had lack of coordination. My parents live 20 minutes to the closest ER. I was at the same hospital; I recommended she call 911 immediately. She followed my advice and dad was delivered to our local ER in just less than 25 minutes. Upon arrival the ER physician assessed my dad for difficulty speaking, weakness on the right side, trouble seeing on the right, lack of coordination and loss of balance. An immediate CT scan was performed. A small infarct was identified along with small vessel disease. My Mom mentioned that he had been not his usual self for the past 24 hours. With this information my father wasn’t eligible for tissue plasminogen activator, tPA. Because of my healthcare experience and new guidelines for stroke patients I had received in-service just days prior regarding the use of the FAST acronym. “Diminishing the long-lasting effects of a CVA depends on rapid recognition and quick interventions†(Para. 10). FAST stands for Face, Arms, Speech, and Time. During the hospital admission the stoke symptoms decreased and he was discharged home. My father lived another 4 years after his first stroke event, when sequent events occurred more of his function decrease and he required a rehab stay twice and with the final event he required skilled care 24 hours per day until his death. The one take away from this discussion is that time matters. The year previous to his stroke, we had noticed a change in his gait and the work-up suggested Parkinson’s disease. In retrospect we feel that his very first stroke symptoms occurred the year prior the witnessed event, when his gait changed. Reference Falkner, A. & Green, S. (2018). Neurological, Perceptual, and Cognitive Complexities. Pathophysiology Clinical Applications for Client Health. Retrieved from https://lc.gcumedia.com/nrs410v/pathophysiology-cl… Response : Stroke otherwise known as a brain attack, occurs when the blood flowing to an area of the brain, is haltered by a rupture or thrombus in a blood vessel supplying the area (Falkner & Green, 2018). Also, once this occurs the function of that portion of the brain is altered of lost due to death of brain cells. According to the Center for Disease Control and prevention (CDC), cerebrovascular accident (CVA) is one of the leading causes of adult disability in the United States and approximately 80% of the CVAs are preventable (Falkner & Green, 2018). Stroke often has a sudden onset and it’s important for caretakers and patients, to know the signs of CVA. These signs include numbness or weakness in face, arm or leg, confusion, slurred speech, visual changes, difficulty walking, dizziness, los of balance and severe headache with unknown cause (Falkner & Green, 2018). Risk factors contributing to CVA are; high cholesterol, obesity, increase stress, diabetes, cardiovascular diseases, family history and hypertension. Mayo Clinic states that CVA could be controlling blood pressure, lower cholesterol and saturated fat in diet, quitting tobacco usage, exercising and consuming a diet rich in fruits and vegetables (MayoClinic, 2019). Also, medications that helps with preventing a stroke involves anti-platelet or anticoagulant medications. Coumadin (Warfin) is often used as well, but its high important that the patient takes this medication as prescribed to avoid complications. Patients who are risk for stroke, suffering from an of the listed risk factors, should try modifying there health sooner than later. In addition, a patient experiencing any unexplainable symptom should consult with his/her primary care provider and get evaluated. If the patient’s symptoms indicate possible CVA, the provider will order A computerized tomography (CT) scan, Magnetic resonance imaging (MRI), Carotid ultrasound or a Cerebral angiogram (MayoClinic, 2019). By educating patients and their families, about the warning signs and early onset of stroke, the risk would decrease drastically. References Falkner, A & Green, S.Z. (2018). Neurological, Perceptual, and Cognitive Complexities. Retrieved from https://lc.gcumedia.com/nrs410v/pathophysiology-clinical-applications-for-client-health/v1.1/#/chapter/2 Mayo Clinic. (2019). Stroke. Retrieved from mayocli Response three: Parkinson’s disease is a progressively debilitating disease that grossly affects the motor function. It is characterized by four primary symptoms: tremor, muscle rigidity, bradykinesia (slow movement) and postural instability. These symptoms occur due to overstimulation of the basal ganglia by acetylcholine. Overstimation of the basal ganglia by acetylcholine occurs because degeneration of the substantia nigra results in decreased dopamine production. This allows acetylcholine to dominate, making smooth, controlled movement difficult. Risk factors of Parkinson’s disease include onset of symptoms between age 40 to 70, chronic use of antipsychotic medication, exposure to environmental toxins and chemicals solvent, common in men and genetic predisposition. Client with Parkinson’s disease often exhibit stooped posture, muscle rigidity, tremors/ pill-rolling tremors of the finger, slow, monotonous speech and slow, shuffling and propulsive gait. There is no information on how to prevent Parkinson’s disease currently. The disease cannot be cured but can be managed through medication therapy. Maintain client mobility for as long as possible, monitor swallowing and maintain adequate nutrition and weigh, monitor mental and cognitive status and promote client communication for as long as possible. Medication can take several weeks of use beofore improvement of symptoms is seen. While the client is taking a combination of medications, maintenance of therapeutic medication level is necessary for adequate control. Reference Norma J.E.H. et. al. (2016). RN Adult Medical Surgical Nursing.(10th ed.). Retrieved from https://www.atitesting.co
