NURS 6501 WEEK 8 Case Study Analysis Example

NURS 6501 WEEK 8 Case Study Analysis

In the middle of eating dinner with his wife, a 74-year-old man with a history of HTN and tobacco use begins to talk slowly, dribble from the left side of his mouth, and experience unexpected weakness in his left hand. When the man’s wife inquires about his well-being, the patient dismisses any difficulties. The client’s symptoms develop during the next ten minutes to the point where he can hardly lift his arm and find it difficult to stand. The patient maintains that there are no issues. While placing a 911 call, the wife chairs the man. The purpose of this paper is to investigate the musculoskeletal and neurological physiologic processes causing these symptoms, to describe how these processes interact to influence the person, and to look into any racial or ethnic characteristics that could affect physiological functioning.

Neurological And Musculoskeletal Pathophysiologic Processes

The patient in the situation above appears to have experienced a cerebrovascular accident (CVA), often known as a stroke. The patient had a higher risk of having a stroke because of his history of cigarette smoking and hypertension (HTN). The patient was more likely to get a stroke because smoking narrows the blood vessels and HTN then seeks to push more volume down the blood vessel. The client displayed the following musculoskeletal and neurological symptoms, all of which were obvious evidence of a stroke: slight left face droop, left arm not defying gravity, and mild left leg drift (Abdelsalam et al., 2020).

A stroke’s pathogenesis can be described as a rapid neurological outburst brought on by reduced blood flow to the brain (Kuriakose and Xiao, 2020). Studies have shown that two internal carotids control blood flow to the brain from the front, while two vertebral arteries, sometimes known as the circle of Willis, control blood flow from the back (Kuriakose & Xiao, 2020). Three different types of strokes result from blockages in the brain that cause interruptions.

As previously mentioned, a stroke happens when blockages in the blood arteries in the brain cause them to malfunction. The rupture of the blood arteries and the movement of clots and lipids within the vessels are two potential causes of the obstruction (Reverté-Villarroya et al., 2021). By changing the physiological functions of the muscles, the blockage that precipitates numbness in the nerve system impacts the individual’s musculoskeletal system. A defect in the pyramidal tract fiber causes the pathophysiology, which adversely impacts neuronal transmission, impairs voluntary movement, changes the limbs, and makes it difficult for the client to move and speak (O’Donnell & Yuan, 2018). The patient’s race was another element that increased his danger. The pathophysiology of strokes also heavily depends on racial and ethnic factors.

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Racial/Ethnic Variables

As previously said, racial and ethnic factors are very important in determining which groups are more prone to strokes than others. African Americans have the highest rates of hypertension compared to Caucasians, which makes them more susceptible to strokes (Bell et al., 2018). Age and sex are two more characteristics that might make some persons more susceptible to having a stroke than others. Further factors that might raise a person’s risk of strokes include smoking, inadequate levels of exercise, and bad eating habits, all of which can contribute to other conditions including diabetes and obesity.

How These Processes Interact        

A stroke in the left brain will affect the right portion of the body. You may experience memory loss, right-side paralysis, speech problems, and slow/cautious conduct as a result of the injury. According to McCance and Huether (2019), a stroke that affects the right portion of the brain will also have an impact on the left half of the body. The expected adverse effects include memory loss, left-side paralysis, eyesight problems, and impulsive/quick conduct. The person can become mute or unable to function below the neck if the stroke damages the brain stem. Dementia and despair are additional side effects of stroke.


One of the main causes of mortality in the US is stroke. Diabetes, obesity, hypertension, and a family heritage of stroke are among stroke risk factors. There are two forms of stroke: ischemic, which involves a lack of oxygen, and hemorrhagic, which involves brain hemorrhage. The risk of having a stroke is roughly two times higher for African Americans. The etiology of the patient’s stroke from the case study has already been covered. The pathophysiology of stroke in the patient provided in the case study has been discussed above.


Abdelsalam, M., Abu-Hegazy, M., El-Hadaad, H., Wahba, H., Egila, H., & Esmael, A. (2020). Pathophysiology, mechanism, and outcome of ischemic stroke in cancer patients. Journal of Stroke and Cerebrovascular Diseases, 29(11), 105299.

Bell, C. N., Thorpe, R. J., Bowie, J. V., & LaVeist, T. A. (2018). Race disparities in cardiovascular disease risk factors within socioeconomic status strata. Annals of Epidemiology, 28(3), 147-152.

Kuriakose, D., & Xiao, Z. (2020). Pathophysiology and treatment of stroke: Present status and future perspectives. International Journal of Molecular Sciences, 21(20), 7609.

McCance, K. L., & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). Mosby.

O’Donnell, M. E., & Yuan, J. X.-J. (2018). Pathophysiology of stroke: The many and varied contributions of brain microvasculature. American Journal of Physiology-Cell Physiology, 315(3), C341–C342.

Reverté-Villarroya, S., Suñer-Soler, R., Font-Mayolas, S., Dávalos Errando, A., SaurasColón, E., Gras-Navarro, A., Adell-Lleixà, M., Casanova-Garrigós, G., Gil-Mateu, E., & Berenguer-Poblet, M. (2021). Influence of pain and discomfort in stroke patients on coping strategies and changes in behavior and lifestyle. Brain Sciences, 11(6), 804.



An understanding of the neurological and musculoskeletal systems is a critically important component of disease and disorder diagnosis and treatment. This importance is magnified by the impact that that these two systems can have on each other. A variety of factors and circumstances affecting the emergence and severity of issues in one system can also have a role in the performance of the other.


Effective analysis often requires an understanding that goes beyond these systems and their mutual impact. For example, patient characteristics such as, racial and ethnic variables can play a role.

An understanding of the symptoms of alterations in neurological and musculoskeletal systems is a critical step in diagnosis and treatment. For APRNs this understanding can also help educate patients and guide them through their treatment plans.

In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factors in the diagnosis, and you explain the implications to patient health.

Required Media

Module 5 Overview with Dr. Tara Harris

Dr. Tara Harris reviews the structure of Module 5 as well as the expectations for the module. Consider how you will manage your time as you review your media and Learning Resources throughout the module to prepare for your Knowledge Check and your Assignment. (3m)

Khan Academy. (2019b). Ischemic stroke

Retrieved from
Note: The approximate length of the media program is 8 minutes. (2019, June 12). Osteoporosis – causes, symptoms, diagnosis, treatment, pathology
Links to an external site. [Video file]. Retrieved from
Note: The approximate length of the media program is 9 minutes.

To prepare:

By Day 1 of this week, you will be assigned to a specific case study scenario for this Case Study Assignment. Please see the “Announcements” section of the classroom for your assignment from your Instructor.

Welcome to module 5 which is a two-week module (weeks 7 & 8). We will focus on the neurological and musculoskeletal systems. The module 5 assignment is due by day 7 of week 8. The case scenario is given below:

74-year-old male with a history of hypertension and smoking, is having dinner with his wife when he develops sudden onset of difficulty speaking, with drooling from the left side of his mouth, and weakness in his left hand. His wife asks him if he is all right and the patient denies any difficulty. His symptoms progress over the next 10 minutes until he cannot lift his arm and has trouble standing. The patient continues to deny any problems. The wife sits the man in a chair and calls 911. The EMS squad arrives within 5 minutes. Upon arrival in the ED, patient‘s blood pressure was 178/94, pulse 78 and regular, PaO2 97% on room air. Neuro exam – Cranial nerves- Mild left facial droop. Motor- Right arm and leg extremity with 5/5 strength. Left arm cannot resist gravity, left leg with mild drift. Sensation intact. Neglect- Mild neglect to left side of body. Language- Expressive and receptive language intact.

Be sure to complete all assigned readings and lectures and I am available to answer your questions.

The Assignment (1- to 2-page case study analysis)

In your Case Study Analysis related to the scenario provided, explain the following:

  • Both the neurological and musculoskeletal pathophysiologic processes that would account for the patient presenting these symptoms.
  • Any racial/ethnic variables that may impact physiological functioning.
  • How these processes interact to affect the patient.