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Older Adult with Stroke: A HESI Case Study Analysis
Introduction:
Navigating the complexities of stroke recovery in older adults presents unique challenges for healthcare professionals. This blog post delves into a detailed analysis of a hypothetical HESI case study focusing on an older adult who has experienced a stroke. We'll explore the patient's presentation, relevant medical history, diagnostic findings, nursing assessments, and the development of a comprehensive care plan. This in-depth examination will provide valuable insights into the multifaceted nature of stroke care and equip you with a better understanding of how to approach similar cases. We will focus on the key aspects relevant to HESI exams, highlighting crucial information and critical thinking skills necessary for success.
HESI Case Study: The Patient Profile
Our case study centers on a 78-year-old female patient, Mrs. Eleanor Vance, admitted to the hospital following a suspected ischemic stroke. Mrs. Vance presents with right-sided weakness, slurred speech (dysarthria), and mild confusion. Her medical history includes hypertension, atrial fibrillation, and hyperlipidemia, all significant risk factors for stroke. She lives alone but has a supportive daughter who visits regularly.
Neurological Assessment and Diagnostic Findings:
Initial Assessment:
Upon admission, Mrs. Vance's Glasgow Coma Scale (GCS) score was 14, indicating mild impairment of consciousness. Her neurological examination revealed right-sided hemiparesis (weakness), affecting her arm and leg. She exhibited facial droop on the right side. Her speech was significantly impaired, and she struggled to articulate complete sentences. Basic cranial nerve function was assessed, revealing deficits consistent with right-sided brain involvement.
Diagnostic Imaging:
A computed tomography (CT) scan of the brain confirmed an ischemic stroke in the left middle cerebral artery territory. This finding explains the neurological deficits observed on the right side of her body. Further investigations may include Magnetic Resonance Imaging (MRI) for a more detailed assessment of the stroke's extent and potential for recovery.
Nursing Assessment and Care Plan Development:
Prioritizing Needs:
The nursing assessment focuses on several key areas: airway, breathing, circulation (ABCs), neurological status, and the patient's overall comfort. Maintaining a patent airway is crucial, especially considering the potential for aspiration due to dysphagia (difficulty swallowing). Continuous monitoring of vital signs and neurological function is essential. Pain management is also a priority, as stroke can cause significant discomfort.
Addressing Specific Needs:
Impaired Mobility: Physical therapy is vital to help Mrs. Vance regain mobility and strength on her right side. Occupational therapy will focus on adapting activities of daily living (ADLs) to her current limitations.
Dysphagia Management: A speech-language pathologist (SLP) will assess her swallowing ability and recommend strategies to prevent aspiration, such as modified diets and swallowing exercises.
Cognitive Impairment: Addressing Mrs. Vance’s mild confusion involves creating a calm and supportive environment, providing clear and concise instructions, and involving her daughter in her care.
Medication Management: Her existing medications for hypertension, atrial fibrillation, and hyperlipidemia need careful monitoring and adjustment as needed. Thrombolytic therapy (tissue plasminogen activator or tPA) might be considered if administered within the appropriate timeframe after stroke onset. Anticoagulation therapy will likely be initiated to prevent further thromboembolic events.
Collaborative Care and Patient Outcomes:
Effective management of Mrs. Vance's stroke requires a collaborative approach involving physicians, nurses, physical therapists, occupational therapists, speech-language pathologists, and her family. Regular reassessments are essential to monitor her progress and adjust the care plan as needed. The goal is to maximize her functional independence and quality of life following her stroke. Prognosis depends on various factors, including the extent of the brain damage, the patient's age and overall health, and the effectiveness of the rehabilitation program.
Discharge Planning:
Discharge planning should begin early in the hospitalization process. This involves assessing Mrs. Vance's ability to safely return home, determining the need for home healthcare services, and providing her family with the necessary education and support.
Conclusion:
This case study highlights the complex nature of stroke care in older adults. A thorough assessment, collaborative approach, and individualized care plan are critical for successful outcomes. Effective communication with the patient and her family is paramount throughout the entire process. Understanding the intricacies of stroke pathophysiology, diagnostic procedures, and rehabilitation strategies is essential for healthcare professionals working with this population.
FAQs:
1. What are the common complications associated with stroke in older adults? Common complications include pneumonia (due to aspiration), pressure sores, deep vein thrombosis (DVT), and urinary tract infections (UTIs).
2. How does age affect stroke recovery? Older adults often experience slower recovery rates compared to younger individuals due to age-related physiological changes and potentially pre-existing conditions.
3. What is the role of family support in stroke rehabilitation? Family support is crucial for providing emotional support, assisting with ADLs, and adhering to the prescribed rehabilitation plan at home.
4. What are some preventative measures for stroke? Maintaining a healthy lifestyle, including regular exercise, a balanced diet, and managing risk factors like hypertension and hyperlipidemia, is key to stroke prevention.
5. Where can I find more information on stroke management? The National Stroke Association and the American Heart Association websites provide extensive resources on stroke prevention, treatment, and rehabilitation.
| older adult with stroke hesi case study: Gerontology Nursing Case Studies Donna J. Bowles, MSN, EdD, RN, CNE, 2015-04-08 Praise for the first edition: “This is an excellent teaching guide and resource manual for instructors, gerontological nursing students, and practicing nurses and social workers who wish to learn more about geriatric concerns and care. It will be kept by nursing students long after they graduate as a guide to resources that will be valuable throughout their nursing careers. As a home care nurse working mainly with the geriatric community, I found the resources helpful in my practice. As an instructor, I found the book to be a very useful guide for teaching geriatrics.” Score: 90, 4 Stars —Doody’s Medical Reviews “[This] is a unique volume that effectively addresses the lack of gerontology case studies for use with undergraduate nursing students. Case studies are a pedagogically powerful approach to active learning that offer opportunities to apply content to clinical practice.” —The Gerontologist “The case narrative approach of this book promotes active learning that is more meaningful to students (and practicing nurses) and more likely to increase the transfer of evidence into practice. An excellent resource for faculty (staff educators) to facilitate critical learning skills.” —Liz Capezuti, PhD, RN, FAAN Dr. John W. Rowe Professor in Successful Aging Co-Director, Hartford Institute for Geriatric Nursing New York University College of Nursing Vivid case examples help guide nurses in developing appropriate interventions that include complementary and alternative health therapies and provide a basis for evaluating outcomes. Exercises interspersed throughout each case study include numerous open-ended and multiple-choice questions to facilitate learning and critical thinking. The text is unique in that some of the presented cases focus on psychosocial issues such as gambling addiction, hoarding behavior, emergency preparedness, and long-distance caregiving. Cases also depict geriatric clients who are living healthy, productive lives to counter myths and negative attitudes about older adults. Scenarios demonstrating ethical dilemmas prepare students to appropriately respond to “gray area” situations. The text is geared for AACN and NLN accreditation and is organized according to the needs of actual clinical settings. With cases that take place in the home and community or within primary, acute, and long-term care facilities, this book will be useful for courses specific to gerontology nursing or across any nursing curriculum. New to the Second Edition: A completely new section of Aging Issues Affecting the Family New cases addressing health care disparities, aging in place, and prevention of catheter-associated urinary tract infection Additional contemporary case studies The addition of Quality for Safety in Nursing Education (QSEN) initiatives A greater focus on prioritization and delegation of client’s needs infused throughout exercises |
| older adult with stroke hesi case study: Enhancing Cognitive Fitness in Adults PAULA HARTMAN-STEIN, Asenath LaRue, 2011-08-02 Late life is characterized by great diversity in memory and other cognitive functions. Although a substantial proportion of older adults suffer from Alzheimer’s disease or another form of dementia, a majority retain a high level of cognitive skills throughout the life span. Identifying factors that sustain and enhance cognitive well-being is a growing area of original and translational research. In 2009, there are as many as 5.2 million Americans living with Alzheimer’s disease, and that figure is expected to grow to as many as 16 million by 2050. One in six women and one in 10 men who live to be at least age 55 will develop Alzheimer’s disease in their remaining lifetime. Approximately 10 million of the 78 million baby boomers who were alive in 2008 can expect to develop Alzheimer’s disease. Seventy percent of people with Alzheimer’s disease live at home, cared for by family and friends. In 2008, 9.8 million family members, friends, and neighbors provided unpaid care for someone with Alzheimer’s disease or another form of dementia. The direct costs to Medicare and Medicaid for care of people with Alzheimer’s disease amount to more than $148 billion annually (from Alzheimer’s Association, 2008 Alzheimer’s Disease Facts and Figures). This book will highlight the research foundations behind brain fitness interventions as well as showcase innovative community-based programs to maintain and promote mental fitness and intervene with adults with cognitive impairment. The emphasis is on illustrating the nuts and bolts of setting up and utilizing cognitive health programs in the community, not just the laboratory. |
| older adult with stroke hesi case study: Strengthening Forensic Science in the United States National Research Council, Division on Engineering and Physical Sciences, Committee on Applied and Theoretical Statistics, Policy and Global Affairs, Committee on Science, Technology, and Law, Committee on Identifying the Needs of the Forensic Sciences Community, 2009-07-29 Scores of talented and dedicated people serve the forensic science community, performing vitally important work. However, they are often constrained by lack of adequate resources, sound policies, and national support. It is clear that change and advancements, both systematic and scientific, are needed in a number of forensic science disciplines to ensure the reliability of work, establish enforceable standards, and promote best practices with consistent application. Strengthening Forensic Science in the United States: A Path Forward provides a detailed plan for addressing these needs and suggests the creation of a new government entity, the National Institute of Forensic Science, to establish and enforce standards within the forensic science community. The benefits of improving and regulating the forensic science disciplines are clear: assisting law enforcement officials, enhancing homeland security, and reducing the risk of wrongful conviction and exoneration. Strengthening Forensic Science in the United States gives a full account of what is needed to advance the forensic science disciplines, including upgrading of systems and organizational structures, better training, widespread adoption of uniform and enforceable best practices, and mandatory certification and accreditation programs. While this book provides an essential call-to-action for congress and policy makers, it also serves as a vital tool for law enforcement agencies, criminal prosecutors and attorneys, and forensic science educators. |
| older adult with stroke hesi case study: Alternative Medicine for the Elderly P. Cherniack, 2003-04-23 This book on complementary alternative medicine (CAM) for the Elderly provides a critical and objective evaluation of alternative medical therapy for the elderly. The focus on practical aspects such as adverse effects and general risks of various therapeutic methods makes it a valuable reference book for the general practitioner, for geriatricians and professionals within the area of alternative medicine, but also for interested laypeople. In the three sections, Epidemiology, Types of CAM, and Common Medical Problems and CAM, a broad range of issues are covered. They range from drug compliance in elderly people to CAM in the treatment of specific conditions such as pulmonary diseases, arthritis or cancer. The above features and in particular the unbiased approach to discuss the pros and cons of CAM make this publication a must-have for everybody searching for detailed information on alternative medicine for the elderly. |
| older adult with stroke hesi case study: Democracy and Education John Dewey, 2012-04-27 DIVThe distinguished educator and philosopher discusses his revolutionary vision of education, stressing growth, experience, and activity as factors that promote a democratic character in students and lead to the advancement of self and society. /div |
| older adult with stroke hesi case study: Colour-Coded Constance Backhouse, 1999-11-20 Historically Canadians have considered themselves to be more or less free of racial prejudice. Although this conception has been challenged in recent years, it has not been completely dispelled. In Colour-Coded, Constance Backhouse illustrates the tenacious hold that white supremacy had on our legal system in the first half of this century, and underscores the damaging legacy of inequality that continues today. Backhouse presents detailed narratives of six court cases, each giving evidence of blatant racism created and enforced through law. The cases focus on Aboriginal, Inuit, Chinese-Canadian, and African-Canadian individuals, taking us from the criminal prosecution of traditional Aboriginal dance to the trial of members of the 'Ku Klux Klan of Kanada.' From thousands of possibilities, Backhouse has selected studies that constitute central moments in the legal history of race in Canada. Her selection also considers a wide range of legal forums, including administrative rulings by municipal councils, criminal trials before police magistrates, and criminal and civil cases heard by the highest courts in the provinces and by the Supreme Court of Canada. The extensive and detailed documentation presented here leaves no doubt that the Canadian legal system played a dominant role in creating and preserving racial discrimination. A central message of this book is that racism is deeply embedded in Canadian history despite Canada's reputation as a raceless society. Winner of the Joseph Brant Award, presented by the Ontario Historical Society |
| older adult with stroke hesi case study: Applications of Toxicogenomic Technologies to Predictive Toxicology and Risk Assessment National Research Council, Division on Earth and Life Studies, Board on Life Sciences, Board on Environmental Studies and Toxicology, Committee on Applications of Toxicogenomic Technologies to Predictive Toxicology, 2007-11-19 The new field of toxicogenomics presents a potentially powerful set of tools to better understand the health effects of exposures to toxicants in the environment. At the request of the National Institute of Environmental Health Sciences, the National Research Council assembled a committee to identify the benefits of toxicogenomics, the challenges to achieving them, and potential approaches to overcoming such challenges. The report concludes that realizing the potential of toxicogenomics to improve public health decisions will require a concerted effort to generate data, make use of existing data, and study data in new waysâ€an effort requiring funding, interagency coordination, and data management strategies. |
| older adult with stroke hesi case study: Having Our Say Sarah L. Delany, A. Elizabeth Delany, Amy Hill Hearth, 2023-01-03 Warm, feisty, and intelligent, the Delany sisters speak their mind in a book that is at once a vital historical record and a moving portrait of two remarkable women who continued to love, laugh, and embrace life after over a hundred years of living side by side. Their sharp memories tell us about the post-Reconstruction South and Booker T. Washington, Harlem’s Golden Age and Langston Hughes, W. E. B. Du Bois and Paul Robeson. Bessie Delany breaks barriers to become a dentist; Sadie Delany quietly integrates the New York City system as a high school teacher. Their extraordinary story makes an important contribution to our nation’s heritage—and an indelible impression on our lives. |
| older adult with stroke hesi case study: Evidence-Based Geriatric Nursing Protocols for Best Practice Marie Boltz, PhD, RN, GNP-BC, FGSA, FAAN, Elizabeth Capezuti, PhD, RN, FAAN, Terry T. Fulmer, PhD, RN, FAAN, DeAnne Zwicker, DrNP, APRN, BC, 2016-03-28 This new edition of one of the premier references for geriatric nurses in hospital, long-term, and community settings delivers current guidelines, real-life case studies, and evidence-based protocols developed by master educators and practitioners. With a focus on improving quality of care, cost-effectiveness, and outcome, the fifth edition is updated to provide the most current information about care of common clinical conditions and issues in older patients. Several new expert contributors present current guidelines about hip fractures, frailty, perioperative and postoperative care, palliative care, and senior-friendly emergency departments. Additionally, chapters have been reorganized to enhance logical flow of content and easy information retrieval. Protocols, systematically tested by more than 300 participating NICHE (Nurses Improving Care for Health system Elders) hospitals‚ are organized in a consistent format and include an overview, evidence-based assessment and intervention strategies, and an illustrative case study with discussion. Additionally, protocols are embedded within chapter text, providing the context and detailed evidence for each. Chapter objectives, annotated references,and evidence ratings for each protocol are provided along with resources for additional study. New to the Fifth Edition: Reorganized to enhance logical flow of information and ease of use Updated and revised Includes new contributions from expert educators and practitioners Provides new chapters on perioperative and postoperative care, general surgical care, care of hip fracture, palliative care, and the senior-friendly emergency department Key Features: Includes PowerPoints and a test bank for instructors Delivers evidence-based, current guidelines and protocols for care of common clinical conditions in the older person Illustrates the application of clinical protocols to real-life practice through case studies and discussion Edited by nationally known geriatric leaders who are endorsed by the Hartford Institute for Geriatric Nursing and NICHE Written for nursing students, nurse leaders, and practitioners at all levels, including those in specialty roles |
| older adult with stroke hesi case study: Pocket Nephrology Wooin Ahn, Jai Radhakrishnan, 2019-09-23 Pocket Nephrology is a practical, high-yield reference offering current, evidence-based practices and expert guidance from physicians at the world-renowned Columbia University Medical Center. Featuring an easy-to-use loose-leaf format, it can be used as a portable diagnosis and treatment reference, as a quick dosage check, as a review for complex glomerular diseases and acid–base physiology, and for board preparation. |
| older adult with stroke hesi case study: Neeb's Fundamentals of Mental Health Nursing Linda M Gorman, Robynn Anwar, 2014-02-12 Here’s the must-know information LPN/LVN students need to care for patients with mental health disorders where they’ll encounter them—in general patient care settings. An easy-to-read, conversational writing style shows you how to recognize and respond to the most important mental health issues. You’ll also explore important communication techniques to use with your patients, ethical and legal issues, and alternative and complementary treatments. |
| older adult with stroke hesi case study: Beyond the HIPAA Privacy Rule Institute of Medicine, Board on Health Care Services, Board on Health Sciences Policy, Committee on Health Research and the Privacy of Health Information: The HIPAA Privacy Rule, 2009-03-24 In the realm of health care, privacy protections are needed to preserve patients' dignity and prevent possible harms. Ten years ago, to address these concerns as well as set guidelines for ethical health research, Congress called for a set of federal standards now known as the HIPAA Privacy Rule. In its 2009 report, Beyond the HIPAA Privacy Rule: Enhancing Privacy, Improving Health Through Research, the Institute of Medicine's Committee on Health Research and the Privacy of Health Information concludes that the HIPAA Privacy Rule does not protect privacy as well as it should, and that it impedes important health research. |
| older adult with stroke hesi case study: Healthy People 2010 Government Publishing Office, 2013-02-20 Healthy People 2010 Final Review presents a quantitative end-of-decade assessment of progress in achieving the Healthy People 2010 objectives and goals over the course of the decade. It continues the series of profiles of the nation's health objectives as an integral part of the Department of Health and Human Services' disease and health promotion initiative for the decade that began in 2000. This report presents a summary of progress toward achieving the Healthy People 2010 goals of: Increasing quality and years of healthy life, andEliminating health disparities. This publication provides the final tracking data used to present a quantitative assessment of progress for the 969 objectives in the 28 Healthy People 2010 Focus Areas. A summary of progress for the Healthy People 2010 Leading Health indicators is also presented.NOTE: NO FURTHER DISCOUNT FOR THIS PRODUCT. Significantly reduced price. Overstock List Price |
| older adult with stroke hesi case study: Three Guineas Virginia Woolf, 2017-02-16 “Three Guineas” is a 1938 extended essay by Virginia Woolf that deals with the subjects of fascism, feminism, and war. The book was written in response to three requests for donations by three different feminist organisations and contains a statement on feminine purpose. Not to be missed by fans and collectors of Feminist literature. Adeline Virginia Woolf (1882–1941) was an English writer. She is widely hailed as being among the most influential modernist authors of the 20th century and a pioneer of stream of consciousness narration. Woolf was a central figure in the feminist criticism movement of the 1970s, her works having inspired countless women to take up the cause. She suffered numerous nervous breakdowns during her life primarily as a result of the deaths of family members, and it is now believed that she may have suffered from bipolar disorder. In 1941, Woolf drowned herself in the River Ouse at Lewes, aged 59. Contents include: “Virginia Woolf”, “One”, “Notes and References”, “Two”, “Notes and References”, “Three”, “Notes and References”. Other notable works by this author include: “To the Lighthouse” (1927), “Orlando” (1928), and “A Room of One's Own” (1929). Read & Co. Great Essays is proudly republishing this classic essay now complete with a specially-commissioned new biography of the author. |
| older adult with stroke hesi case study: The Memoirs of Lady Hyegyong JaHyun Kim Haboush, 2013-09-14 Lady Hyegyong's memoirs, which recount the chilling murder of her husband by his father, form one of the best known and most popular classics of Korean literature. From 1795 until 1805 Lady Hyegyong composed this masterpiece, depicting a court life Shakespearean in its pathos, drama, and grandeur. Presented in its social, cultural, and historical contexts, this first complete English translation opens a door into a world teeming with conflicting passions, political intrigue, and the daily preoccupations of a deeply intelligent and articulate woman. JaHyun Kim Haboush's accurate, fluid translation captures the intimate and expressive voice of this consummate storyteller. Reissued nearly twenty years after its initial publication with a new foreword by Dorothy Ko, The Memoirs of Lady Hyegyong is a unique exploration of Korean selfhood and an extraordinary example of autobiography in the premodern era. |
| older adult with stroke hesi case study: Varcarolis' Foundations of Psychiatric Mental Health Nursing Margaret Jordan Halter, 2014 Rev. ed. of: Foundations of psychiatric mental health nursing / [edited by] Elizabeth M. Varcarolis, Margaret Jordan Halter. 6th ed. c2010. |
| older adult with stroke hesi case study: Childhood Cancer Survivors Nancy Keene, Wendy Hobbie, Kathy Ruccione, 2014-03-01 More than 325,000 children, teens, and adults in the United States are survivors of childhood cancer. The surgery, radiation, chemotherapy, and stem cell transplants used to cure children can affect growing bodies and developing minds. If survivors know of these potential problems, they can take steps to identify, cope with, or treat them early if they do develop. The third edition of Childhood Cancer Survivors charts the territory for survivors by providing state-of-the-art information about: Medical late effects from treatment Emotional aspects of surviving cancer Schedules for follow-up care Challenges in the heath-care system Lifestyle choices to maximize health Discrimination in employment or insurance Woven throughout the text are stories from more than 100 survivors and parents. Authors Keene, Hobbie, and Ruccione are experts in the field of childhood cancer. Keene is the mother of a survivor of childhood leukemia and the author of several books including Childhood Leukemia, Childhood Cancer, Educating the Child with Cancer, and Chemo, Craziness & Comfort. Hobbie is Associate Director of the Cancer Survivorship Program at Children's Hospital of Philadelphia. Ruccione is Co-Director of the HOPE (Hematology-Oncology Psychosocial and Education) Program in the Children's Center for Cancer and Blood Diseases at Children's Hospital Los Angeles. |
| older adult with stroke hesi case study: The Ultimate Guide To Choosing a Medical Specialty Brian Freeman, 2004-01-09 The first medical specialty selection guide written by residents for students! Provides an inside look at the issues surrounding medical specialty selection, blending first-hand knowledge with useful facts and statistics, such as salary information, employment data, and match statistics. Focuses on all the major specialties and features firsthand portrayals of each by current residents. Also includes a guide to personality characteristics that are predominate with practitioners of each specialty. “A terrific mixture of objective information as well as factual data make this book an easy, informative, and interesting read.” --Review from a 4th year Medical Student |
| older adult with stroke hesi case study: Social Laws - An Outline of Sociology G. Tarde, 2012-11-07 This early work, originally published in 1899, contains the leading ideas of one of the most authoritative and distinguished writers in sociology and social psychology at the turn of the last century. Gabriel Tarde here outlines his three principal works on general sociology and the internal bond that unites them. A fascinating read for any sociologist, amateur or professional alike. Contents Include: Editors Preface; Authors Preface; Introduction; The Repetition of Phenomena; The Opposition of Phenomena; The Adaptation of Phenomena; Conclusion. Many of the earliest books, particularly those dating back to the 1900s and before, are now extremely scarce and increasingly expensive. We are republishing these classic works in affordable, high quality, modern editions, using the original text and artwork. |
| older adult with stroke hesi case study: Understanding Family Care Mike Nolan, Gordon Grant, John Keady, 1996 Integrates several perspectives to provide a more holistic understanding of the needs of caregivers in informal family care, shedding light on the burdens and satisfactions of caring and the coping strategies of caregivers. Presents a new longitudinal model of caring and its various stages, and discusses implications for policy and practice. For practitioners and managers in health and social services, as well as students of social science, nursing, gerontology, and social work. Distributed by Taylor and Francis. Annotation copyright by Book News, Inc., Portland, OR |
| older adult with stroke hesi case study: The Patient Self-Determination Act Lawrence P. Ulrich, 2001-07-18 The Patient Self-Determination Act of 1990 required medical facilities to provide patients with written notification of their right to refuse or consent to medical treatment. Using this Act as an important vehicle for improving the health care decisionmaking process, Lawrence P. Ulrich explains the social, legal, and ethical background to the Act by focusing on well-known cases such as those of Karen Quinlan and Nancy Cruzan, and he explores ways in which physicians and other caregivers can help patients face the complex issues in contemporary health care practices. According to Ulrich, health care facilities often address the letter of the law in a merely perfunctory way, even though the Act integrates all the major ethical issues in health care today. Ulrich argues that well-designed conversations between clinicians and patients or their surrogates will not only assist in preserving patient dignity — which is at the heart of the Act—but will also help institutions to manage the liability issues that the Act may have introduced. He particularly emphasizes developing effective advance directives. Ulrich examines related issues, such as the negative effect of managed care on patient self-determination, and concludes with a seldom-discussed issue: the importance of being a responsible patient. Showing how the Patient Self-Determination Act can be a linchpin of more meaningful and effective communication between patient and caregiver, this book provides concrete guidance to health care professionals, medical ethicists, and patient-rights advocates. |
| older adult with stroke hesi case study: The Structural Conservation of Panel Paintings Kathleen Dardes, Andrea Rothe, 1998-10-29 This volume presents the proceedings of an international symposium organized by the Getty Conservation Institute and the J. Paul Getty Museum. The first conference of its kind in twenty years, the symposium assembled an international group of conservators of painted panels, and gave them the opportunity to discuss their philosophies and share their work methods. Illustrated in color throughout, this volume presents thirty-one papers grouped into four topic areas: Wood Science and Technology, History of Panel-Manufacturing Techniques, History of the Structural Conservation of Panel Paintings, and Current Approaches to the Structural Conservation of Panel Paintings. |
| older adult with stroke hesi case study: Educating Students with High Ability Catherine Clark, Bruce M. Shore, 2004 Perceived to be academically successful, highly able or gifted children often appear not to require much teacher assistance and subsequently are given less attention. However, these students do have needs, and this book seeks to explain what these are and ways in which teachers can begin to meet them, even when working in difficult circumstances with little support. This revised second edition includes chapters on identification of high ability and the impact of that identification, unrecognised ability, teaching methods, underachievement, student/teacher relations, organisation of learning, gender and culture, general advice to teachers, parental and community involvement. |
| older adult with stroke hesi case study: Educating Nurses Patricia Benner, Molly Sutphen, Victoria Leonard, Lisa Day, 2009-12-09 Praise for Educating Nurses This book represents a call to arms, a call for nursing educators and programs to step up in our preparation of nurses. This book will incite controversy, wonderful debate, and dialogue among nurses and others. It is a must-read for every nurse educator and for every nurse that yearns for nursing to acknowledge and reach for the real difference that nursing can make in safety and quality in health care. —Beverly Malone, chief executive officer, National League for Nursing This book describes specific steps that will enable a new system to improve both nursing formation and patient care. It provides a timely and essential element to health care reform. —David C. Leach, former executive director, Accreditation Council for Graduate Medical Education The ideas about caregiving developed here make a profoundly philosophical and intellectually innovative contribution to medicine as well as all healing professions, and to anyone concerned with ethics. This groundbreaking work is both paradigm-shifting and delightful to read. —Jodi Halpern, author, From Detached Concern to Empathy: Humanizing Medical Practice This book is a landmark work in professional education! It is a must-read for all practicing and aspiring nurse educators, administrators, policy makers, and, yes, nursing students. —Christine A. Tanner, senior editor, Journal of Nursing Education This work has profound implications for nurse executives and frontline managers. —Eloise Balasco Cathcart, coordinator, Graduate Program in Nursing Administration, New York University |
| older adult with stroke hesi case study: The Masque of the Red Death Edgar Allan Poe, 2020-08-01 The Masque of the Red Death, originally published as The Mask of the Red Death: A Fantasy, is an 1842 short story by American writer Edgar Allan Poe. The story follows Prince Prospero's attempts to avoid a dangerous plague, known as the Red Death, by hiding in his abbey. He, along with many other wealthy nobles, hosts a masquerade ballwithin seven rooms of the abbey, each decorated with a different color. In the midst of their revelry, a mysterious figure disguised as a Red Death victim enters and makes his way through each of the rooms. Prospero dies after confronting this stranger, whose costume proves to contain nothing tangible inside it; the guests also die in turn. Poe's story follows many traditions of Gothic fiction and is often analyzed as an allegory about the inevitability of death, though some critics advise against an allegorical reading. Many different interpretations have been presented, as well as attempts to identify the true nature of the titular disease. The story was first published in May 1842 in Graham's Magazineand has since been adapted in many different forms, including a 1964 film starring Vincent Price. |
| older adult with stroke hesi case study: Freshwater Fishes of North America Melvin L. Warren Jr., Brooks M. Burr, 2020-07-14 The highly anticipated second volume of Freshwater Fishes of North America, a monumental, fully illustrated reference that provides comprehensive details on the freshwater fishes of the United States, Canada, and Mexico. When the first volume of Freshwater Fishes of North America was published, it was immediately hailed as the definitive reference in the field. Readers have been fervently awaiting the next volume in this encompassing three-book set ever since. Now complete, volume 2, covering families Characidae to Poeciliidae, is the result of decades of analysis by leading fish experts from universities and research laboratories across North America. Each volume in this authoritative synthesis covers the ecology, morphology, reproduction, distribution, behavior, taxonomy, conservation, and the fossil record of the included North American fish families. The encyclopedic reviews of each family are accompanied by color photographs (nearly 250 in this volume alone), range maps, and artwork created by noted fish illustrator Joseph R. Tomelleri. The result is a rich textual and visual experience that covers everything known about the diversity, natural history, ecology, and biology of North American freshwater fishes. Volume 2 covers the following North American families of fishes: Characidae (Characins) Ictaluridae (North American Catfishes) Ariidae (Sea Catfishes) Heptapteridae (Three-barbeled Catfishes) Osmeridae (Smelts) Esociformes (Esocidae, Pikes and Umbridae, Mudminnows) Percopsidae (Trout-perches) Amblyopsidae (Cavefishes) Aphredoderidae (Pirate Perches) Gadidae (Cods and Cuskfishes) Mugilidae (Mullets) Atherinopsidae (New World Silversides) Beloniformes (Needlefishes and Halfbeaks) Rivulidae (New World Rivulines) Profundulidae (Middle American Killifishes) Goodeidae (Goodeids) Fundulidae (Topminnows) Cyprinodontidae (Pupfishes) Poeciliidae (Livebearers) The chapter authors of Volume 2 are: Gianetta Adams Clyde Barbour Micah Bennett Ricardo Bentancur-R. Peter B. Z. Berendzen Brooks M. Burr Mollie Cashner Robert C. Cashner Bruce B. Collette Matthew Davis Alice F. Echelle Anthony A. Echelle Fernando Galvez Michael Ghedotti Nicholas Gidmark Terry Grande Robert L. Hopkins Lauren M. Kuehne Frank McCormick Norman Mercado-Silva Ann U. O'Connell Martin T. O'Connell Julian D. Olden Claudia Patricia Ornelas-Garcia Mark Sabaj Perez Kyle R. Piller Steven Powers Jacob Schaefer Juan J. Schmitter-Soto Andrew M. Simons Roger A. Tabor Cheryl Thiele Matthew Thomas Melvin L. Warren, Jr. Mark V. H. Wilson |
| older adult with stroke hesi case study: The Taming of Chance Ian Hacking, 1990-08-31 This book combines detailed scientific historical research with characteristic philosophic breadth and verve. |
| older adult with stroke hesi case study: True Cost Accounting for Food Barbara Gemmill-Herren, Lauren E. Baker, Paula A. Daniels, 2021-06-22 This book explains how True Cost Accounting is an effective tool we can use to address the pervasive imbalance in our food system. Calls are coming from all quarters that the food system is broken and needs a radical transformation. A system that feeds many yet continues to create both extreme hunger and diet-related diseases, and one which has significant environmental impacts, is not serving the world adequately. This volume argues that True Cost Accounting in our food system can create a framework for a systemic shift. What sounds on the surface like a practice relegated to accountants is ultimately a call for a new lens on the valuation of food and a new relationship with the food we eat, starting with the reform of a system out of balance. From the true cost of corn, rice and water, to incentives for soil health, the chapters economically compare conventional and regenerative, more equitable farming practices in and food system structures, including taking an unflinching look at the true cost of cheap labour. Overall, this volume points towards the potential for our food system to be more human-centred than profit-centred and one that has a more respectful relationship to the planet. It sets forth a path forward based on True Cost Accounting for food. This path seeks to fix our current food metrics, in policy and in practice, by applying a holistic lens that evaluates the actual costs and benefits of different food systems, and the impacts and dependencies between natural systems, human systems, agriculture and food systems. This volume is essential reading for professionals and policymakers involved in developing and reforming the food system, as well as students and scholars working on food policy, food systems and sustainability. |
| older adult with stroke hesi case study: Computer Key-Stroke Logging and Writing Kirk Sullivan, Eva Lindgren, 2021-10-25 Computer keystroke logging is an exciting development in writing research methodology that allows a document's evolution to be logged and then replayed as if the document were being written for the first time. Computer keystroke logged data allows analysis of the revisions and pauses made by authors during the writing of texts. Computer Keystroke Logging and Writing: Methods and Applications is the first book to successfully collect a group of leading computer keystroke logging researchers into a single volume and provide an invaluable introduction and overview of this dynamic area of research. This volume provides the reader unfamiliar with writing research an introduction to the field and it provides the reader unfamiliar with the technique a sound background in keystroke logging technology and an understanding of its potential in writing research. |
| older adult with stroke hesi case study: Gender Equality and Work-Life Balance Sarah Blithe, 2015-06-05 Pressure to achieve work-life balance has recently become a significant part of the cultural fabric of working life in United States. A very few privileged employees tout their ability to find balance between their careers and the rest of their lives, but most employees face considerable organizational and economic constraints which hamper their ability to maintain a reasonable balance between paid work and other life aspects—and it is not only women who struggle. Increasingly men find it difficult to do it all. Women have long noted the near impossibility of balancing multiple roles, but it is only recently that men have been encouraged to see themselves beyond their breadwinner selves. Gender Equality and Work-Life Balance describes the work-life practices of men in the United States. The purpose is to increase gender equality at work for all employees. With a focus on leave policy inequalities, this book argues that men experience a phenomenon called the glass handcuffs, which prevents them from leaving work to participate fully in their families, homes, and other life events, highlighting the cultural, institutional, organizational, and occupational conditions which make gender equality in work-life policy usage difficult. This social justice book ultimately draws conclusions about how to minimize inequalities at work. Gender Equality and Work-Life Balance is unique as it laces together some theoretical concepts which have little previous association, including entrepreneurialism; leave policy, occupational identity, and the economic necessities of families. This book will therefore be of particular interest to researches and academics alike in the disciplines of Gender studies, Human Resource Management, Employment Relations, Sociology and Cultural Studies. |
| older adult with stroke hesi case study: Directness and Indirectness Across Cultures Sara Mills, Karen Grainger, 2016-01-26 This book analyses the complex relationship between directness, indirectness, politeness and impoliteness. Definitions of directness and indirectness are discussed and problematised from a discursive theoretical perspective. |
| older adult with stroke hesi case study: Dimensions of Japanese Society K. Henshall, 1999-06-23 Japan remains one of the most intriguing yet least understood nations. In a much needed, balanced and comprehensive analysis, among other remarkable revelations, this book presents for the first time a vital key to understanding the organisation of Japan's society and the behaviour of its people. The Japanese are not driven by a universal morality based on Good and Evil, but by broad aesthetic concepts based on Pure and Impure. What they include as 'impure' will surprise many readers. |
| older adult with stroke hesi case study: Forever Today Deborah Wearing, 2011-07-31 Clive Wearing has one of the most extreme cases of amnesia ever known. In 1985, a virus completely destroyed a part of his brain essential for memory, leaving him trapped in a limbo of the constant present. Every conscious moment is for him as if he has just come round from a long coma, an endlessly repeating loop of awakening. A brilliant conductor and BBC music producer, Clive was at the height of his success when the illness struck. As damaged as Clive was, the musical part of his brain seemed unaffected, as was his passionate love for Deborah, his wife. For seven years he was kept in the London hospital where the ambulance first dropped him off, because there was nowhere else for him to go. Deborah desperately searched for treatments and campaigned for better care. After Clive was finally established in a new special hospital, she fled to America to start her life over again. But she found she could never love another the way she loved Clive. Then Clive's memory unaccountably began to improve, ten years after the illness first struck. She returned to England. Today, although Clive still lives in care, and still has the worst case of amnesia in the world, he continues to improve. They renewed their marriage vows in 2002. This is the story of a life lived outside time, a story that questions and redefines the essence of what it means to be human. It is also the story of a marriage, of a bond that runs deeper than conscious thought. |
| older adult with stroke hesi case study: Oral History As History Dominique Legros, Yukon. Cultural Services Branch, 2007 |
| older adult with stroke hesi case study: The Gazelle in Ancient Egyptian Art Åsa Strandberg, 2009 |
| older adult with stroke hesi case study: Placing the Academy Jennifer Sinor, Rona Kaufman, 2007-03-31 Twenty-one writers answer the call for literature that addresses who we are by understanding where we are--where, for each of them, being in some way part of academia. In personal essays, they imaginatively delineate and engage the diverse, occasionally unexpected play of place in shaping them, writers and teachers in varied environments, with unique experiences and distinctive world views, and reconfiguring for them conjunctions of identity and setting, here, there, everywhere, and in between. Contents I Introduction Writing Place, Jennifer Sinor II Here Six Kinds of Rain: Searching for a Place in the Academy, Kathleen Dean Moore and Erin E. Moore The Work the Landscape Calls Us To, Michael Sowder Valley Language, Diana Garcia What I Learned from the Campus Plumber, Charles Bergman M-I-Crooked Letter-Crooked Letter, Katherine Fischer On Frogs, Poems, and Teaching at a Rural Community College, Sean W. Henne III There Levittown Breeds Anarchists Film at 11:00, Kathryn T. Flannery Living in a Transformed Desert, Mitsuye Yamada A More Fortunate Destiny, Jayne Brim Box Imagined Vietnams, Charles Waugh IV Everywhere Teaching on Stolen Ground, Deborah A. Miranda The Blind Teaching the Blind: The Academic as Naturalist, or Not, Robert Michael Pyle Where Are You From? Lee Torda V In Between Going Away to Think, Scott Slovic Fronteriza Consciousness: The Site and Language of the Academy and of Life, Norma Elia Cantu Bones of Summer, Mary Clearman Blew Singing, Speaking, and Seeing a World, Janice M. Gould Making Places Work: Felt Sense, Identity, and Teaching, Jeffrey M. Buchanan VI Coda Running in Place: The Personal at Work, in Motion, on Campus, and in the Neighborhood, Rona Kaufman |
| older adult with stroke hesi case study: The Foundations of Nursing Cliff Evans, Emma Tippins, 2008-06-01 |
| older adult with stroke hesi case study: On My Own at 107 Sarah L. Delany, 1998-01-20 Sarah Delany recounts her transition from mourning the loss of her sister, Bessie, to a renewed zest for life, symbolized by Bessie's flower garden. |
| older adult with stroke hesi case study: Thinkers on Education Zaghloul Morsy, 1997 |
| older adult with stroke hesi case study: The Genre of Trolls Camilla Asplund Ingemark, 2004 |
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