Mr. Michael, a 61-year-old man, experienced sudden onset slurred speech and facial droop on the left side while eating breakfast. His wife recognized the symptoms as a potential stroke and called an ambulance. At the hospital, the nurses collected his medical history and examined him, finding signs of motor weakness on his left side. They assessed his consciousness, vision, speech, and other neurological functions. The doctors ordered imaging tests and diagnosed him with a stroke. He received treatments like thrombolysis and physiotherapy, and the nurses provided health education to help manage his condition.

1. MEDICAL SURGICAL
NURSING

2. Scenario
 Mr. Michael, 61 years old, while eating breakfast he
experienced sudden onset slurring of speech, had
facial droop on his left hand side with weakness in
left side upper and lower limbs. His wife Mary
spotted these sudden onset of symptoms and
immediately called for an ambulance, which arrived
within 15 minutes. He was diagnosed with
STROKE.

3.  Past medical history
 Past surgical history
 Medication history
 Social history
 Family history
 Vital signs
History collection

4. Check for confusion
Check for facial droop
Check for slurred speech
Check for motor weakness-upper and lower limb
Check for decreased tone
Check for altered sensation
Check for left sided neglect
Physical examination

5.  Motor function (Both right and left sides of the body-
upper and lower limb)
Check for Unilateral muscle weakness
Check for facial grimace
Check for grip strength
Check for arm strength
Check for falls
Assessment

6.  Level of consciousness (GCS assessment)
 Level of conscious commands
 Assessment of best gaze
 Assessment of visual field
 Testing of visual field
 Assessment of aphasia
 Assessment of dysarthria
 Assessment of extinction and inattention

7. Investigations
 Laboratory investigation
 Computer tomography (CT SCAN)
 Magnetic resonance imaging (MRI scan)
 Cerebral angiography

8. Medical management
 Thrombolysis and endovascular mechanical
thrombectomy
 Physiotherapy
 Management of patient with stroke
Health education

9. THANK YOU