Posted: January 24th, 2022

Scenario 1: 74-year-old male with a history of hypertension and smoking

Scenario 1: 74-year-old male with a history of hypertension and smoking, is having dinner with his wife when he develops sudden onset of difficulty speaking, with drooling from the left side of his mouth, and weakness in his left hand. His wife asks him if he is all right and the patient denies any difficulty. His symptoms progress over the next 10 minutes until he cannot lift his arm and has trouble standing. The patient continues to deny any problems. The wife sits the man in a chair and calls 911. The EMS squad arrives within 5 minutes. Upon arrival in the ED, patient‘s blood pressure was 178/94, pulse 78 and regular, PaO2 97% on room air. Neuro exam – Cranial nerves- Mild left facial droop. Motor- Right arm and leg extremity with 5/5 strength. Left arm cannot resist gravity, left leg with mild drift. Sensation intact. Neglect- Mild neglect to left side of body. Language- Expressive and receptive language intact.

Mild to moderate dysarthria. Able to protect airway.

Please do a 1 to 2-page case study analysis. In your Case Study Analysis related to the scenario provided, explain the following:

Both the neurological and musculoskeletal pathophysiologic processes that would account for the patient presenting these symptoms.
Any racial/ethnic variables that may impact physiological functioning.
How these processes interact to affect the patient
3-5 references

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A 74-year-old man who has a history of hypertension and smoking is having dinner with his wife when he experiences a sudden and severe loss of verbal fluency, as well as excessive salivation and drooling from the left side of his mouth and weakness in his left hand. His wife inquires as to his well-being, and the patient categorically denies having any difficulties. Over the next 10 minutes, his symptoms worsen to the point that he is unable to elevate his arm and has difficulty standing. The patient continues to deny that he or she has any problems. The man is seated in a chair by his wife, who dials 911. Within 5 minutes, an ambulance is dispatched. When the patient arrived in the emergency department, his blood pressure was 178/94, his pulse was 78 and regular, and his oxygen saturation was 97 percent on room air. Neurological examination reveals mild left face drooping as a result of the cranial nerves. Motor- 5/5 strength in the right arm and leg extremity on both sides. The left arm is unable to withstand gravity, while the left leg is slightly drifting. The sensation is still there. Neglect- There is some neglect on the left side of the body. Language is complete, both in terms of expression and reception.

Dysarthria ranging from mild to moderate. Capable of protecting the airway.

Please provide a case study analysis of one to two pages in length. Explain the following in your Case Study Analysis in relation to the scenario that has been provided:

These symptoms could be caused by both neurological and musculoskeletal pathophysiologic processes in the patient who is presenting with these symptoms.
Anything related to race or ethnicity that may have an impact on physiological functioning.
How these processes interact with one another to have an impact on the patient
3-5 sources should be cited

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