Diagnostic Case Discussion: Subarachnoid Hemorrhage

Diagnostic Case Discussion: Subarachnoid Hemorrhage
Brief Patient History
A 64 year old female presented to the emergency department with a chief complaint of severe headache
which she rated at a 6 on a 1 – 10 pain scale. She stated that she had “never had a headache like this
before”. The headache had a 1-day onset with no other symptoms and Acetaminophen achieved mild
Clinical Assessment
The patient scored 15/15 on the Glascow Coma Scale, was moving all extremities spontaneously with
full strength, pupils were equal and reactive to light. BP of 138/69, regular pulse rate of 83
beats/minute, respirations of 20 breaths/minute with oxygen saturation of 96% on room air. Her
temperature was 37.3C. She denied complaints of neck stiffness, nausea or vomiting, but was
experiencing some photophobia. Her past medical history included mild hypertension, migraine
headaches and smoked a half pack cigarettes a day for 40 years. She lived alone and could normally
manage her duties without restriction.
Diagnostic Information
A non-contrast CT scan of the head showed an 11 x 13 mm nodule in the left posterior communicating
artery which was indicative of a large aneurysm. There was no evidence of intraparenchymal blood.
Medical Diagnosis
Subarachnoid Hemorrhage
1. What is the clinical definition for the diagnosis?
2. What are the factors which can cause this clinical condition?
3. What are your patient’s contributing factors (history and clinical data)?
4. What additional clinical data would you like to see?
5. What signs and symptoms do you expect of this physical presentation? Which ones are present
in your patient?
a. Neurological
b. Respiratory
c. Cardiovascular
d. Skin
e. Gastro-intestinal
f. Genito-urinary
6. What major outcomes do you expect to achieve for this patient?
7. What problems or risks must be managed to achieve these outcomes?
8. What interventions must be initiated to monitor, prevent, manage, or eliminate the problems and
risks identified?
a. What types of orders would you expect to see?
i. Monitoring
ii. Classification of meds (ie, anti-infectives, anti-emetics, etc)
iii. Type of IV fluid preferred / rate?
iv. Type of oxygen therapy
v. Additional diagnostic studies
vi. Treatments

9. What would be your “worst case” complication for this patient?
a. What are the warning signs and symptoms that your patient might be reaching this level?
(include clinical and diagnostic findings).

10. What possible learning needs would you anticipate for this patient?
11. What cultural and age-related factors might have a bearing on the patient’s plan of care?

Complete Answer:

Get Instant Help in Homework Asap
Get Instant Help in Homework Asap
Calculate your paper price
Pages (550 words)
Approximate price: -
Open chat
Hello 👋
Thank you for choosing our assignment help service!
How can I help you?