Why do Robert’s symptoms increase in the first two days? Why is he given glucocorticoids?
Where’s My Hand?
Robert is a 67 y.o. male who has a history of hypertension. He is a retired executive and can be found in his garden on most days. One day as he is working in his garden, he begins to notice numbness in his right hand. He tries to finish, but the numbness is spreading. He goes into the house and tries to talk to his wife, but is unable to get the words out. She calls 911 and he is rushed to the hospital. He is admitted to the hospital with a Cerebrovascular Accident.
Over the next two days, Robert’s symptoms increase. He is given glucocorticoids, but not tissue plasminogen activator (tPA). He is also put on oxygen. After 3-4 days, Robert is once again able to speak a few words, but his right upper and lower extremities are flaccid.
- a) Why do Robert’s symptoms increase in the first two days? Why is he given glucocorticoids?
- b) Based on the fact that Robert was not given tPA, what is the most likely cause of the CVA?
- c) Which side of the brain was involved in this CVA? How do you know? What does “flaccid” mean and will Robert’s extremities stay flaccid if he does not gain the ability to move them?
- d) There will be a team approach to Robert’s recovery. Describe the role that the physical therapist, occupational therapist, speech-language pathologist, and social worker will play in Robert’s recovery. Give at least 2-3 examples of what each of these people will do for him
