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ST Thomas University Cerebrovascular Accidents Paper and Responses

Daniel Kevins

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  • List the risk factors for cerebrovascular accidents and why?
  • What cultures are at higher risk and why?
  • Describe the 0 to 4+ scale for scoring deep tendon reflexes.
  • What would you expect to find in a patient with diabetic peripheral neuropathy?
  • Share any experience you have encountered and elaborate.

Submission Instructions:

  • Your initial post must be at least 600 words, formatted, and cited in current APA style, 7 edition with support from at least two academic sources.
  • You must respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts and supporting your opinion with a reference. Response posts must be at least 150 words. Your response (reply) posts are worth 2 points (1 point per response). Your post will include a salutation, response (150 words), and a reference.
  • Quotes “…” cannot be used at a higher learning level for your assignments, so sentences need to be paraphrased and referenced.
  • Acceptable references include scholarly journal articles or primary legal sources (statutes, court opinions), journal articles, and books published in the last five years—no websites or videos to be referenced without prior approval. 
  • MATERIALS:
  • Read and watch the lecture resources & materials below early in the week to help you respond to the discussion questions and to complete your assignment(s).(Note: The citations below are provided for your research convenience. You should always cross reference the current APA guide for correct styling of citations and references in your academic work.)Read

hi,

here I have attached the documents for the peer response, please remember to use at least 150 words in the response, excluding the salutation and the references. I need to submit it tomorrow, you can use the same references.

peer response 1 (salmon) Cerebrovascular accidents (CVA) include the malfunctioning of the brain caused by a decline in its blood supply. It is also called paralysis or hemiplegia and is linked to heart diseases. The common risk factor is hypertension because it causes potential deterioration of blood vessels due to high pressure (Minhas et al., 2016). Another risk factor is diabetes because it also impacts the blood pressure in the body. High cholesterol and obesity also increase the risk of CVA because they influence the flow of blood across vessels due to the narrowing of the lumen. Smoking and drinking could also damage the blood vessels leading to CVA. Moreover, heart disease is also a CVA risk factor because it is associated with congestion of valvular failure. Other factors such as medication and age-related degeneration could also lead to the limited blood supply to the brain.

According to Boehme et al. (2018), CVA is prevalent across specific genetic identities or cultures. According to numerous studies on how genetics shape CVA risk factors, it is evident that African Americans are at a higher risk for CVA when compared to whites. At the same time, Hispanic Americans and American Alaska Natives or American Indians are at a greater risk of CVA and related complications when compared to whites. Boehme et al. (2018) found out that the risk for intracerebral and subarachnoid hemorrhages is higher among African American younger adults as well as among Indian Americans. At the same time, these two groups are equally overrepresented in other health complications predetermining CVA factors.

The deep tendon reflexes are clinically graded based on five points on the 0 to 4+ scale. The value 0 usually represents no response and is always abnormal. The second level on the scale is 1+, which represents a slight present response that could either be normal or abnormal. The third level is 2+ and is identified as a brisk response that is normal. The fourth reading is 3+ representing a very brisk response that could either be normal or abnormal. The final value n the scale is 4+, identified as a tap elicits that is always abnormal because it is a repeating reflex (clonus). The criteria used to determine if 1+ and 3+ are abnormal or normal depends on the previous history of the patient or the nature of the previous reflexes. Other factors to consider to arrive at an accurate interpretation include the strength and tone of the muscle (Rodriguez & De Jesus, 2021).

Diabetic peripheral neuropathy results from an extended period of high blood sugar levels that eventually lead to nerve damage. A few or debilitating symptoms could characterize such an occurrence. Therefore, a patient with this condition could have a feeling of numbness or shooting pain from time to time. Diabetic peripheral neuropathy could also lead to loss of balance, deformed foot, soreness or blisters, and exaggerated sensation (Carmichael et al., 2021). A memorable experience occurred when I was attached to a local healthcare facility. A patient came complaining of shooting pain accompanied by loss of balance. At first, the assessment process did not reveal any substantial information based on the subjective data collected. However, the history of the patient provided key clues for further objective evaluation.

References

Boehme, A. K., Esenwa, C., & Elkind, M. S. (2017). Stroke Risk Factors, Genetics, and Prevention. Circulation Research, 120(3), 472–495. https://doi.org/10.1161/CIRCRESAHA.116.308398 (Links to an external site.)

Carmichael, J., Fadavi, H., Ishibashi, F., Shore, A. C., & Tavakoli, M. (2021). Advances in Screening, Early Diagnosis and Accurate Staging of Diabetic Neuropathy. Frontiers in Endocrinology, 12, 671257. https://doi.org/10.3389/fendo.2021.671257 (Links to an external site.)

Minhas, S. V., Goyal, P., & Patel, A. A. (2016). What are the Risk Factors for Cerebrovascular Accidents After Elective Orthopaedic Surgery? Clinical Orthopedics and Related Research, 474(3), 611–618. https://doi.org/10.1007/s11999-015-4496-2 (Links to an external site.)Rodriguez-Beato, F. Y. & De Jesus, O. (2021). Physiology, Deep Tendon Reflexes. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK562238/

peer response 2 (Zapata)

List the risk factors for cerebrovascular accidents and why?
A cerebrovascular accident, otherwise known as a stroke, is when there is a loss of blood flow to a part of the brain and can result in brain tissue damage. There are a number of factors that can put an individual at risk for having a stroke. Factors include old age, gender (strokes are more likely in males, except for the ages of 35 – 44, and over 85 years of age), genetic factors, race/ethnicity (African Americans have a higher risk of stroke than Caucasians), previous heart attack or stroke, history of cardiovascular diseases, hypertension, smoking cigarettes, diabetes, high cholesterol, poor diet and nutrition, physical inactivity, obesity, extreme alcohol use, illegal drug use, and more. Although oftentimes, strokes do not lead to death, they often do lead to disability (Norrving, 2015).

What cultures are at higher risk and why?
Although anyone is prone to suffering from a stroke if conditions are met, there are a few cultures that seem to be at higher risk than others. Two cultures that are at higher risk to suffering from a stroke include African Americans and Hispanic Americans. Racial and ethnic minorities appear to have less time to perform physical activities (exercise) which contributes to higher rates of diabetes, obesity, and hypertension, which are contributing factors that can increase the risk of having a stroke. Racial and ethnic minorities have also been found to have less education, harder accessibility to health care, and experience poverty: all are also contributing factors to one’s health and the likelihood of suffering from a stroke.

Describe the 0 to 4+ scale for scoring deep tendon reflexes.
To determine deep tendon reflexes, we use a scale from 0 – 4+ to grade muscle-tendon response following a quick tap (Lees, 2019). The grades are as follows:
0 = response absent. Sign of issue present, as no response is abnormal.
1+ = a small, but noticeable response. May or may not be abnormal.
2+ = an energetic response. Normal and healthy.
3+ = a very energetic response. May or may not be abnormal.
4+ = tapping the tendon triggers multiple reflexes, or a clonus (a repeating reflex). This response is abnormal.

What would you expect to find in a patient with diabetic peripheral neuropathy?
Diabetic peripheral neuropathy is when there is nerve damage caused by excessive and high blood sugar levels and diabetes. In a patient suffering from diabetic peripheral neuropathy, I would expect to find issues with their legs, feet, and hands, most commonly. Sensations such as numbness, loss of feeling, and even pain will present themselves with diabetic peripheral neuropathy. Early symptoms can include numbness, a feeling of sharpness, buzzing, pinching, cold, burning, prickling, pins and needles feeling, and tingling.

Share any experience you have encountered and elaborate.
I have had many patients throughout my career come in and be diagnosed with diabetic peripheral neuropathy. They usually experience the same symptoms mentioned above: sensations of numbness, tingling, and pain. But usually, the patient will deny having the condition due to these symptoms coming on slowly over the course of their life. I have to explain to them that it is normal for the symptoms to appear slowly over time, and because of that, they are usually overlooked. What seems to help is that I explain how I have members in my family who suffer from diabetes and have diabetic peripheral neuropathy and how important it is to identify these symptoms and manage them with healthy exercise and lifestyle. When you can relate to a patient’s health issues, I find it helps convince them of the right choices to make.

References

Lees, A. J., & Hurwitz, B. (2019). Testing the reflexes. BMJ: British Medical Journal (Online), 366 doi:http://dx.doi.org.ezproxylocal.library.nova.edu/10…

Norrving, B., Davis, S. M., Feigin, V. L., Mensah, G. A., Sacco, R. L., & Varghese, C. (2015). Stroke prevention worldwide – what could make it work. Neuroepidemiology, 45(3), 215-220. doi:http://dx.doi.org.ezproxylocal.library.nova.edu/10…

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Daniel Kevins

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