You are consulted to visit a 72 year old male client who had a stroke last year which left both his upper and lower right sided extremities weakened. He is obese and has a history of smoking for 57 years. His history also includes being diagnosed with type 2 diabetic, high blood pressure, coronary artery disease, polycythemia, and atrial fibrillation. His father died of an MI at age 53. Both of his parents had type 2 diabetes. His mother dies of cancer. His paternal grandfather had 2 strokes, 0neyear apart, dying two weeks after the second stroke.

1. What types of extremity paralysis ( weaknesses) can occur in strokes and how do they differ? What type of weakness does this patient exhibit?
2. The lesion that caused the motor function problem in this patient is located on which side of the brain? Why does it occur in this manner?
3. Given the history of this patient, what type of stroke did this patient have,
   ischemic, or hemorrhagic? Please provide your rationale.
4. What is the relationship between atrial fibrillation, and the stroke
5. What other risk factors are identified for this patient and what is the relationship of these to a stroke?
6. Your patient’s wife tells you “My husband’s grandfather had a stroke and could not talk, but he could talk> My husband can not walk, but can talk. I do not understand Why?” The APN would address this issue in what manner? What information is shared?
7. The patient’s wife adds, the doctor said to call him if he suffered a TIA. I thought TIA’s go away. Why is this important and how will I know it is happening? The APN addresses this situation in what manner. What information will be shared?
8. How do adult strokes differ from pediatric strokes?