Part 2: Understanding and Promoting Interprofessional Practice and Collaboration

Summary

This transcript captures a multidisciplinary team discussion about a 35-year-old woman recovering from a stroke. The patient, an attorney and single parent, faces challenges including expressive aphasia, swallowing difficulties, and right-sided weakness. The team discusses her medication, nutritional needs, pain management, and therapy plans, focusing on improving her quality of life through coordinated efforts. Family involvement, cultural considerations, and a timeline for progress are also emphasized, while ensuring her transition home is carefully planned with necessary home care services and psychological support.

Takeaways

• 😀 The patient is a 35-year-old right-handed woman who suffered a stroke, likely due to uncontrolled hypertension and excessive caffeine consumption.
• 😀 She works as an attorney on a high-pressure case and is a single parent living with her daughter and mother in Brooklyn.
• 😀 The patient is currently being treated with medications like nifedipine, telmisartan, and furosemide to manage her hypertension.
• 😀 The patient suffers from expressive aphasia, with challenges in finding words and some frustration during speech, which is being addressed through therapy.
• 😀 There are concerns about her ability to swallow, and she is on a mechanical soft diet with nectar-thickened liquids.
• 😀 The patient is also experiencing malnutrition and prefers a more liberalized diet, particularly with potassium-rich foods.
• 😀 Occupational therapy has been initiated, focusing on her right-sided weakness and helping her use her left hand during feeding activities.
• 😀 The patient is experiencing significant pain on her right side, which is affecting her sleep and ability to engage in therapy effectively.
• 😀 The healthcare team is considering medications like Gabapentin for nerve pain and using complementary methods such as deep breathing to manage the pain.
• 😀 A discharge plan is being developed, including potential home healthcare services, rehab, and support for her family to assist with her care post-discharge.

Q & A

What is the patient's primary medical condition?

The patient suffered a stroke, likely induced by uncontrolled hypertension and excessive consumption of caffeinated energy drinks.

What are the patient's current medications?

The patient is currently on nifedipine, telmisartan, and furosemide to control her hypertension.

What challenges is the patient facing in terms of speech and language?

The patient has expressive aphasia, specifically anomia, and struggles with word-finding, which is frustrating for her.

What are the patient’s difficulties related to swallowing?

The patient has difficulty swallowing and is currently on a mechanical soft diet with thickened liquids. She finds this hospital diet unappealing and is working with therapy to improve her swallowing ability.

What concerns exist regarding the patient's nutrition?

There are concerns about the patient's low weight and potential malnutrition. The team is focusing on liberalizing her diet and increasing potassium intake while ensuring it aligns with her cultural food preferences.

What role does occupational therapy play in the patient's recovery?

Occupational therapy is addressing the patient's impaired right arm function (her dominant arm), working on compensatory strategies like using the left hand for feeding, and providing support for daily activities such as bathing and dressing.

How is the patient’s post-stroke pain being managed?

The patient is experiencing pain on the right side of her body. Gabapentin is recommended for nerve pain management, alongside complementary therapies such as deep breathing and cognitive behavioral therapy to manage pain during exercises.

What psychological support is being provided to the patient?

The patient is experiencing an adjustment disorder following the stroke. She will continue to have access to psychological support during her stay, and social work will help arrange outpatient psychological support for her and her family after discharge.

What is the plan for the patient's discharge and home care?

The patient’s discharge plan includes home rehabilitation services, nursing assistance, and a home safety assessment. The patient’s mother will need help managing care at home, and the social work team is coordinating insurance coverage and services.

What is the estimated timeline for the patient’s rehabilitation?

The estimated timeline for the patient’s rehabilitation is 2-3 weeks, depending on her progress, with ongoing monitoring of swallowing, pain management, and therapy participation.