Case Study 13-2
Lori L. Lindsey-Clarkston
Lakeview College of Nursing
RN 309 Nursing of the Gerontological Client
January 30, 2011

1.	 I would tell my grandfather that he should make an appointment with his primary care physician as soon as possible.  I would tell him that he should tell the doctor’s office when he calls what symptoms he has been having just like he told me, I would tell him to make sure that he is very insistent that he get an appointment immediately.  I would also tell my grandfather that if he should have more of the same kind of symptoms he should call me or another family member so we could get him to the emergency room to be evaluated.  I would also offer to accompany him to the appointment with his doctor.  The symptoms this man is having are indicative of TIA (transient ischemic attacks).  The symptoms are similar to those of a stroke but they disappeared within minutes (Mauk, 2010).  
2.	The risk factors this man has for stroke is that he is white, male, he is 85 years old, he takes medication for high blood pressure, diabetes, and he has smoked since he was 13 years old even though he has cut back to less than half a pack per week, his father suffered and eventually died from effects of a stroke, I know this because he is my grandfather (Mauk, 2010).  
3.	I would ask him how many of these episodes he has had, how they were similar or different.  How long each episode lasted, if he ever lost consciousness, and what other symptoms he had with the episode besides the ones he had that he told me about.  I would also ask him if he had been taking his medication as prescribed.  I would ask him if he has been having frequent headaches, dizziness, slurred speech, or having weakness in arms or legs that does not subside.  I would ask him to raise his eyebrows, grimace, and smile and stick out his tongue, I would do this to assess for facial drooping, which could be signs of damage from a stroke or TIA (NSA, 2011).
4.	If he has any residual effects, he should be taken to an emergency room immediately; he should see his physician as soon as possible.  He should try smoking cessation techniques, check his blood pressure regularly, make sure he is taking his medication as prescribed, exercise as tolerated but not over exert, follow a diabetic diet, checking his blood sugar level regularly, drink water, getting enough rest and avoid stress as much as possible.  
5.	My grandmother should be told about the episodes.  She must then be educated on the signs of stroke she should be aware if grandfather has another episode.  The signs would be sudden weakness of  arms, face or legs, sudden confusion, ability to speak or understand, trouble seeing out of one or both eyes, trouble walking, dizziness, loss of balance or coordination, and sudden severe headache without cause (NSA, 2011).  Grandmother should also make sure grandfather is eating appropriate foods for diabetes and hypertension.  I would suggest that they take walks together for exercise and encourage grandmother to stop smoking as well.  I would talk to her regarding that fact that embarking on a journey to be healthy together would not only lower the stress level of one or the other being sick of each of them but could prolong their life together. 
6.	Both grandfather and grandmother should be educated on the importance of all that has been discussed above. Additional education would be the importance of immediately calling emergency response if any signs of stroke were evident.  Getting to a medical facility for treatment and evaluation quickly to determine the kind of stroke, hemorrhagic or ischemic will greatly affect the outcome, survival, and quality of living after a stroke (Mauk, 2010).   

References
Mauk, K.L. (2010).  Gerontological nursing competencies for care (2nd ed.). Sudbury, MA: Jones and Bartlett.
National Stroke Association (2011).  Warning signs of stroke. Retrieved from http://www.stroke.org/site/PageServer?pagename=SYMP