Nursing Assignment | Top Universities

L.M. is a 57-yr-old white woman who was referred to the neurosurgery service for management of her temporal-parietal glioblastoma. She was diagnosed after presenting with persistent headaches, a seizure in her HCP’s office, and left side upper visual field loss and neglect. Her MRI/MRA demonstrated a temporal-parietal glioblastoma that extends into the occipital lobes. She is scheduled for surgery to debulk the tumor. L.M.. lives alone and holds a management position. She is concerned about her ability to return to work after her surgery.

L.M. returns from surgery to the neurosurgery unit drowsy but following commands. During the night L.M.. is noted to have a pronator drift of the left arm, her pupils are equal and respond to light, but she has also developed left-sided weakness of both arm and leg and difficulty with answering questions.

Medications: dexamethasone 4 mg q6hr, famotidine, metoclopramide, ondansetron (Zofran), codeine, and levetiracetam (Keppra) since her admitting seizure

Subjective Data

• Left arm and leg are weak and feel numb
• She is trying to answer questions but looks confused and cannot follow commands

Objective Data

• BP 150/90 mm Hg
• Right gaze preference
• Left homonymous hemianopsia
• Left arm weakness (3/5) greater than leg weakness (4/5)
• Decreased sensation on both left arm and leg
• Has speech but not clear. Difficulty with word finding and following commands
• A diagnostic CT scan demonstrates a hemorrhagic stroke into the site of the tumor bed, and temporal-parietal and anterior occipital areas extending into the thalamus.

Questions to Answer:

1. How does L.M.’s diagnosis (glioblastoma) put her at risk for a stroke?
2. Priority Decisions: What are the priority decisions that need to be made regarding safety and self-care related to the left neglect and visual field cut?
3. Patient-Centered Care: What factors should you assess for related to rehabilitation for L.M.?
4. Priority Decisions: What are the priority nursing interventions for L.M.?
5. Priority Decisions: Based on the assessment data provided, what are the priority nursing diagnoses and are there any collaborative problems?
6. Teamwork and Collaboration: What nursing interventions for J.K. can the RN delegate to unlicensed assistive personnel ((UAP)?
7. Teamwork and Collaboration: How can you work together with the interprofessional team to develop and implement strategies to improve communication for L.M..?
8. Safety: How can you ensure safety forL.M. in light of her homonymous hemianopsia and left-sided neglect?
9. Patient-Centered Care: How can you address L.M..’s concerns about her finances and self-care?
10. Patient-Centered Care:L.M.’s family wants to know if her tumor surgery caused her hemorrhagic stroke and if so, what they should watch out for at home.. Get  Nursing Assignments  Help Today