PRECIPITATING

- Work overload
RISK FACTORS - Stress
- Hx Kidney Disease

DISEASE PROCESS

S/S, MANIFESTATION
Nicardipine Drip

Losartan
( 50mg 1 Tab OD )
MEDICATION AND MANAGEMENT

Chronic Stress on the Endothelium

Thrombus Formation Obstruction of Blood Flow HYPERTENSION
LABS AND DIAGNOSIS of Systemic Blood vessels

MEDICAL DIAGNOSIS Elevated Blood Pressure Plaque Rupture

NURSING DIAGNOSIS

Endothelial Damage Advanced plaque formation

Headache
Decreased Cerebral blood flow

(+) Dizziness
Lipid Accumulation Smooth muscle cell proliferation

Significant Decreased in O2 at
ischemic core

Oxidative Modification Formation of Fatty Streaks

Increased Anaerobic metabolism

DECREASED TISSUE PERFUSION R/T

IMPAIRED CEREBRAL CIRCULATION
SECONDARY TO STROKE.
 PREDISPOSING
- Patient E.F. 52y/o, Male
- Family history of DM
- Family history of HTN.
- Lifestyle modifications.

Apidra

Intraperitoneal
"visceral fat", w
Insulin Glargine - organ th
Toujeo ( Subq )

DIABETES MELLITUS
Inflammatory mediators Ad

Endothelial Dysfunction Complex, unc

Atherosclerosis

Carotid Doppler Ultrasound

( Impression: Thickened
bilateral intima media ) Glycation and
Inflammation INSULIN
Oxidative Stress

Atheroma Development Atorvastatin 80mg 1 Hype

Dyslipidemia (High LDL, Low HDL) Decreased Insulin Resistance
Tab OD

Fibrous cap formation LDL penetrates damaged

endothelium. Hyperglycemia Beta c

LDL becomes oxidized, triggering

Li id f ti CBG M it i
 cavity accumulates
which is an endocrine
hat secretes:

Adipokines Free fatty acids

clear actions on body

tissue

N RESISTANCE

erinsulinemia

cell dysfunction
 Decreased ATP production

Dysfuction of So
Increased Anaerobic metabolism
Pum

Metabolic demands exceed ATP

Influx of wat
supply

Cell death Cerebra

Compression o
Microglia Activation
surrounding tissu

Microglia release inflammatory Increased permea

cytokines BB

Infiltration by Pe
Cytokines activate Astrocytes
Ce

Immune cell relea

Astrocytes release more cytokines
Cytok

Stroke Symptom: Slightly Slurred

Inflammation of Brain Tissue
Speech

Clopidogrel
 LDL becomes oxidized, triggering
Lipid core formation CBG Monitoring
inflmmation.

Foam cell formation ( Macrophages

Inflammatory response (Monocytes
ingest oxidized LDL, becoming foam
migrate into the vessel wall.)
odium-Potassium cells.)
mp
RISK FOR RENAL FAILURE AS
MANIFESTED BY INCREASE Increased frequenc
FREQUENCY TO URINATE AND urinate
EDEMA.
ter into cells

Ketoanaloque Mannitol
Ciproflaxacin
( 600mg 1Tab TID ) ( 150cc IV Bolus q

al Edema

As kidney function continues

Initial Insult ( Factors such as High blood
Leads to the buildup of toxins, patient may begin to experien
pressure, Uncontrolled Diabetes,
Reduced blood flow in the kidneys. waste products and fluid retention in such as weakness, swellin
Breakdown of atherosclerosis that
the body. changes in urination, d
of vessels and increases the risk of stroke.
concentrating.
ue damages BBB

Damages to the kidney tissues Progressive decline in kidney

ability of damaged ( nephrons ) function. KIDNEY DISEA
BB

Activates compensatory
eripheral Immune Decreased in kidney function Sodium and Water ret
mechanisms.
ells

ase inflammatory
kines. Date Tested: 04-14-24
Serum Creatinine: Enalap
123 µmol/l

Celecoxib Date tested: 04-19-24

Serum Creatinine: Hydroc
134 µmol/l 25m

Ketarolac Date tested: 04-23-24

Serum Creatinine: Potas
648 µmol/l

Date tested: 04-24-24 Sodium

Serum Creatinine:
808 µmol/l
 EXCESS FLUID VOLUME R/T
cy to DECREASED MOBILITY AS
EVIDENCED BY EDEMA IN LOWER
EXTREMITIES.

q6 ) Furosemide 40mg IV
+2 Pitting edema on both Strict I and O
with Bed Side
lower extremities. monitoring.
Desferral.

to decline, the
nce symptoms
ng (edema),
difficulty Fluid leak out. Clindamycin

Metronidazole

ASE Hydrostatic pressure.

Cefuroxime

Piptaz
Gravity falls down to lower
tention
extremities.

Meropenem

pril 10mg 1Tab

OD

chlorathiazine
mg 1Tab OD

ssium Citrate

m Bicarbonate
50meq
 Clopidogrel

Citicoline
TRANSIENT ISCHEMIC
ATTACK
Aspirin 80mg 1Tab
OD

Vitamin B Complex

CT-Scan
(Impression: Subacute
Ischemic Infarct, pons)
 Right-Sided
Tramadol 50mg PRN
Body Weakness