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NURS1027 Lecture Notes - Intracerebral Hemorrhage, Stroke, Subarachnoid Space

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peterliban
22 Jul 2022
School
George Brown College
Department
NURS
Course
NURS1027
Professor
Sonie Prince

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Document Summary

Strokes are classified on the basis of underlying pathophysiological findings. Inadequate blood flow to the brain from partial or complete occlusion of an artery. * 87% of all strokes are ischemic strokes. A tia is usually a precursor to ischemic stroke. Hemorrhagic: account for approximately 15% of all strokes: result from bleeding into the brain tissue itself or into the subarachnoid space or ventricles. Intracerebral hemorrhage: bleeding within the brain caused by rupture of a vessel, hypertension is the most important cause, hemorrhage commonly occurs during periods of activity. Intracerebral hemorrhage: manifestations, neurological deficits, headache, nausea and/or vomiting, decreased levels of consciousness, hypertension. Most obvious effect of stroke include impairment of: mobility, respiratory function, swallowing and speech, gag reflex, self-care abilities. Characteristic motor deficits: loss of skilled voluntary movement, impairment of integration of movements, alterations in muscle tone, alterations in reflexes.

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Related Questions

Mrs. Tom, a 79 year old female presents to the ER with complaints of a persistent productive cough, fatigue, fever and shortness of breath. Mrs. Tom reports that she has had a persistent cough and shortness of breath with activity for several months. She was given a prescription for antibiotics for a presumed infection 4 weeks ago, with only slight improvement in symptoms. Her past medical history includes stroke 6 months ago. She also smokes 20 cigarettes per day. On exam, she has a fever with decreased lung sounds bilaterally to auscultation with the right side slightly more obvious than the left. She is obviously short of breath and presents with 4-word dyspnea. Her vital signs are BP 110/70, HR 99, SP02 94% on 4 L of oxygen via nasal prongs, Temp 38.9.

 

  1. Identify the infection of inflammatory response that Mrs. Tom is experiencing? (2)

 

  1. Explain the pathology of how smoking affects the innate defense system of the lungs? (5)

 

  1. What diagnostic tools could you expect to be used in this case? (xray,CT,laboratory data etc). (2)

 

  1. Identify risk factors that Mrs. Tom has that are associated with the diagnosis? (3)

 

 

  1. Internal medicine assesses Mrs. Tom and orders a STAT lactate and arterial blood gasses. Based on the patient’s vital signs above, what would you expect to see in the results of these tests? (5)

 

 

 

How many calories in that fast-food meal? Ontario menu labelling legislation takes effect
Jan. 1
CBC News · Posted: Dec 29, 2016
Restaurant-goers in Ontario are going to notice a little extra something on some menus as of Jan.
1: calorie counts.
Legislation that comes into effect Sunday under the Healthy Menu Choices Act, 2015 requires
that all restaurants with 20 or more locations must clearly display the caloric information for any
food and drink items.
Not only will the information have to be on menus, but it will also need to be clearly displayed
on menu boards and even on restaurant apps. Hospitals, schools, daycares and correctional
institutions are exempt.
The Heart and Stroke Foundation supports the initiative, believing that providing people with
more information helps them make better choices.
"Menu labelling is one small thing that empowers parents and empowers Ontarians to take
control of the choices that they make when they're having lunch or dinner at a restaurant," said
Joe Belfontaine, executive director of the Ontario branch of the Heart and Stroke Foundation.
"Certainly it's not the end-all or be-all, but it's an important tool in the toolbox."
Although Ontario is the first province in the country to require nutritional labelling at restaurants,
Belfontaine said that he hopes other provinces will follow suit.
Will it make a difference?
Whether including caloric counts will have any lasting health benefits, however, is questionable.
New York City has had food labelling requirements at restaurants since 2008. Since then,
researchers have attempted to ascertain whether it's made a difference to the city's population.
Calories of each food item appear on a McDonald's drive-thru menu in New York City. The city
made it mandatory for restaurants to display nutritional information since 2008. (Associated
Press)
A 2012 study in the American Journal of Public Health concluded posting calories on foods had
no direct impact on what foods people chose to buy. Over time, it appeared that people simply
ignored the labelling altogether.
A more recent study from Tulane University suggested that the New York City mandate
"plausibly reduced the obesity rate by 2.5 percentage points."
Dr. Sean Wharton, an internal medicine specialist who also runs a weight management and
diabetes clinic in Toronto, believes that the move is a positive one by the government, 
particularly for those who are paying close attention to their nutrition. However, it's likely a
different story for the general population.
"From an overall population level, I'm not so sure it'll have the big impact that we're actually
looking for," Wharton said.
"I don't think it's going to decrease weight from a population basis, but I think an informed
consumer is better at making choices and making judgements."
Wharton also noted that data supporting the idea of health benefits from such labelling is weak.
As well, he said, no studies have found that nutrition intake is any better in a general population
when such measures are undertaken.
While the evidence may be slim for a smaller waistline associated with menu labelling, experts
believe that it's important that people make informed decisions.
"I think it's important for consumers to have choice," Belfontaine said. "I think it's important for
consumers to have the right information."

 

Requiring restaurants to put calorie counts on menus is an example of which mechanism of policy

  •  A. Exhortation
  •  B. Expenditure
  •  C. Taxation
  •  D. Regulation
  •  E. Public Ownership

Dr Wharton suggests that “an informed consumer is better at making choices and making judgements.” What ethical principle does this represent?

  •  A. Autonomy
  •  B. Non-maleficence
  •  C. Beneficence
  •  D. Justice