A 42-year-old female was transferred to Tampa General Hospital from an outside hospital for evaluation of acute ischemic stroke. She has presented to an outside hospital two days prior with acute onset numbness and tingling of bilateral upper extremities and mild expressive aphasia. Her past medical history was significant for migraines with aura. Six months prior to her current presentation, the patient had a transient episode of forgetfulness and confusion for four hours and one month ago the patient had reported an episode of numbness and tingling of her left lower extremity lasting three hours. She did not seek medical attention for these episodes. On initial presentation, the patient had a blood pressure of 128/84mmHg, heart rate of 75 beats per minute and respiratory rate of 16 breaths per minute saturating at 98%, while breathing ambient air. Her lungs were clear to auscultation. Cardiac auscultation did not reveal any murmurs or gallops. Abdomen was non-tender, non-distended without any hepatosplenomegaly. Skin examination was significant for three circular macules ranging 1-3 mm on the right hand. Neurological examination was significant for focal weakness in the distal left upper extremity.
1. What management would you consider and why? Support with evidence from literature and US guidelines?.
2. Select an appropriate theory that impacts lifestyle, culture, and environmental factors on health and health disparity of this patient? Discuss each concepts of the selected theory to the patient care in the scenario 3. Describe the factors that influence your practice and discuss quality initiatives recognizing the contributions of the patient in the scenario? Discuss how you may utilize inter-professional healthcare team approach to improve health outcomes for the given situation?
4. Discuss relevant critical issues in the health care delivery systems and population health appropriate to the situation? Integrate clinical prevention, population health concepts, and health education relevant to the scenario?
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