Nursing Case Study

I. Health History
The subject of my case study is W. K. W.K. is a 95 year old white male who was admitted to Moses Cone Hospital on November 23, 2002. Prior to being admitted to the hospital, W. K. had been in excellent health. His troubles apparently began three weeks prior to being admitted. On November 23, W. K.’s son found him lying on the floor confused, and soaked in urine.

Mr. K. was diagnosed as having an acute cerebral vascular accident. This disorder can also be described as a “stroke”. It occurs when there is an interruption of normal blood flow in one or more of the blood vessels that supply the brain. Thrombosis, embolism, and hemorrhage are the primary causes of a CVA. (Sommers and Johnson 2002) The tissues of the brain become ischemic, leading to hypoxia or anoxia with destruction or necrosis of the neurons, glia, and vasculature. Complications of CVA include unstable blood pressure, sensory and motor impairment, infection, pneumonia, contractures, and pulmonary emboli. CVA is the third leading cause of death in the United States and affects more than 500,000 Americans annually. (Sommers and Johnson 2002)

He was widowed in October of 2001, one daughter has coronary artery disease, one son died of an MI at age 37, and one son died with lung cancer at 57. He had been the primary care giver of his daughter until she was admitted to the hospital three weeks ago. She is dying with a short bowel syndrome and cirrhosis and is now being taken care of in hospice. Soon after being left alone, Mr. K.’s appetite decreased and he had become congested. He was placed on Paxil to treat symptoms of depression. He had also been taking Cipro for congestion. Also his family noticed that he was suffering from confusion. As a result, they brought him into the Emergency Room for evaluation. The Emergency Room doctors performed a CT scan of the brain which revealed evidence of old strokes. The doctors stopped the Cipro and placed him on Z-pack. This seemed to improve his state of confusion, as well as reduce his symptoms of congestion.