Family Nurse Practitioner: Stroke Scenario Analysis Essay (Critical Writing)

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The Likely Diagnosis and Pathophysiology

The current symptoms and history of the patient clearly indicate the occurrence of a cerebrovascular accident (CVA). They are insignificant and, therefore, can be easily attributed to other causes; however, the reported damage of a particular area of the man’s brain and tissue are explicit signs of this condition (Ojaghihaghighi et al., 2017). These factors correspond to right arm weakness and problems speaking, which were confirmed by the patient’s wife. In addition, the neurological symptoms in people with ischemic stroke are frequently misinterpreted as headaches or migraines and occasional seizures accompanied by eye movement disorder (Ojaghihaghighi et al., 2017). These conditions also correlate with the case description and add to the conclusion on the presence of this health issue in the patient and the necessity to plan further management of the emerged problems. Meanwhile, in order to render high-quality medical services to M.I., it is necessary to pay particular attention to the medical history since all of the previously experienced diseases correlate with the symptoms described above.

The confusion based on the considerations connected to the past problems with health, which happened to M.I., encompasses all the mentioned signs. Thus, the deteriorating vision can be attributed both to CVA and frequent migraines (Ojaghihaghighi et al., 2017). The same applies to speech issues, which are typical for strokes and severe headaches at the same time (Ojaghihaghighi et al., 2017). These circumstances determine the need for a more thorough analysis is needed for excluding the possibility of other related diseases and, consequently, preventing the complications in the future. In this way, the rationale for additional examination is presented by pathophysiology and underpinned by the complexity of the case due to the existence of numerous challenges.

The Possibility of Migraine Headache

One of the conditions, which is frequently confused with different types of strokes, is migraines. Nevertheless, they cannot be the cause of the patient’s problems because the accompanying symptoms do not confirm this stance and, on the contrary, contradict it. Despite the fact that these issues are both of a neurological nature and, subsequently, frequently correlate with each other, they are different in essence (Gryglas & Smigiel, 2017). Their association is usually described by numerous theoretical approaches, including ” cortical spreading depression, endovascular dysfunction, vasoconstriction,” and many others (Gryglas & Smigiel, 2017, p. 1). Meanwhile, the only established connection between them is the presence of similar risk factors, such as smoking in M.I. (Gryglas & Smigiel, 2017). This evidence is insufficient for claiming the presence of migraines instead of CVA and comparable problems in the patient and, therefore, should not be viewed as a comprehensive explanation of the existing challenges.

In addition, it should be noted that the critical nature of M.I.’s disease can be explained by paying attention to some other established patterns of the connection between the above issues. Thus, for example, the researchers proved that migraines frequently lead to ischemic stroke (Gryglas & Smigiel, 2017). Besides, reported hypertension and type 2 diabetes mellitus comply with this cause and are the consequences of frequent headaches as well (Gryglas & Smigiel, 2017). In the situation of M.I., however, there are also signs, which are not connected to migraines, for instance, problems speaking. Therefore, this factor should be viewed as one of the risks, which usually leads to such drastic outcomes, but not as the condition itself, which requires treatment in the first place. The above considerations add to the opinion that migraines are not the problem in this situation but other issues, which are presently not involved in the matter.

The Cellular Physiologic Mechanisms in Smoke Cessation

One of the most significant goals in therapy based on the medical history of M.I. is smoke cessation, which is the most critical risk factor in this situation. It correlates with the emergence of various neurological diseases and, more particularly, ischemic stroke (Choi et al., 2017). This recommendation is underpinned by the cellular physiological mechanism connected to this habit, which should be considered with regard to chemical compounds and their effects on the organism. The former is presented by 7000 lethal substances resulting from burning tobacco (Choi et al., 2017). They primarily include “carbon monoxide (CO), hydrogen cyanide, nitrogen oxides, acetaldehyde, benzene, aromatic amines, formaldehyde,” and many other components, which lead to this adverse outcome (Choi et al., 2017, p. 80). The impact is determined by various toxic metabolites in one’s lungs (Choi et al., 2017). Their presence results in further complications of a neurological nature, and they are connected to the case under consideration.

Thus, the cellular physiologic mechanisms related to the above chemicals in one’s body can be described as the change in functioning. It is conditional upon the fact that inhaling the mentioned substances removes oxygen from blood vessels and combines with hemoglobin, thereby disrupting the work of red blood cells (Choi et al., 2017). Subsequently, the collision of healthy and modified cells leads to neurological damage, and the affected arteries become narrow, which prevents the supply of blood to the brain (Choi et al., 2017). As a result, people experience ischemic stroke alongside elevated blood pressure, which adds to the harm caused by the chemicals. Therefore, in order to help M.I., it is crucial to eliminate the specified risks for the man. This requirement is linked to not only the occurred CVA but also to the presence of hypertension and the previous heart attack.

References

Buric, I., Farias, M., Jong, J., Mee, C., & Brazil, I. A. (2017). What is the molecular signature of mind-body interventions? A systematic review of gene expression changes induced by meditation and related practices. Frontiers in Immunology, 8, 1-17.

Choi, S., Krishnan, J., & Ruckmani, K. (2017). Cigarette smoke and related risk factors in neurological disorders: An update. Biomedicine & Pharmacotherapy, 85, 79-86.

Gryglas, A., & Smigiel, R. (2017). Migraine and stroke: What’s the link? what to do? Current Neurology and Neuroscience Reports, 17(3), 1-7.

Ojaghihaghighi, S., Vahdati, S. S., Mikaeilpour, A., & Ramouz, A. (2017). Comparison of neurological clinical manifestation in patients with hemorrhagic and ischemic stroke. World Journal of Emergency Medicine, 8(1), 34-38. Web.

Zhao, M., Wang, S., Zhang, D., Zhang, Y., Deng, X., & Zhao, J. (2017). Journal of Stroke and Cerebrovascular Diseases, 26(10), 2387-2395. Web.

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