Patient case scenario..

Specialties Emergency

Published

Specializes in Alzheimer's, Geriatrics, Chem. Dep..

Well this title is probably not indictative of the topic.

Presentation (yep this is me and I'm not looking for advice, just an ear and a what would you do if

52 year old female ... had had sudden evere dizziness while walking 30" at a moderate pace (exercise) ENJOYING said exercise and the view. The dizziness was such that standing did not relieve it enough to go home; she sat x 15 " was somewhat better except when she stood knew she could not make it home (about 3/4 mile) she walked (stupid me) a little way to a nearby laundromat and asked for help.

Dizziness improved a little but she didn't feel comfortable walking home; still too dizzy. Friend came and took her home, she laid down 45", ok I know 3rd person is irritating but it's too late now lol..

Sat down with friend listening to preaching tape which was relaxing and noticed in 20 min or so her first half tongue getting numb/asleep, lips also. This scared her bec. of poss stroke, still slightly dizzy (but had walked to living room)... it began to increase and she called the ambulance.

Presented to the ER, somewhat tearful, ..- denies episode starting w/ or continuing w/ anxiety and she appears fairly calm other than anxious about the situation. She states when asked that it has been years since a panic attack although often some anxiety (gen'l) - this is not the case at this time other than anxiety over this episode.

has had many med adjustments the past week including abilify x 3 days (d/c'd two days prev.) Trileptal increased from 300 to 400 mg and ambien (on night #5, pharmacist had said no interactions when she called from her friends') Med changes had been due to increased depression, then the abilify caused slight hypomania,

current meds:

levothyroxine 150 mcg

Lisinopril 20 mg

Trileptal 400 mg (100 am 300 pm)

Lamictal 200 at hs

ASA

vitamin

Nexium

Inderal long acting 80 mg for essential tremor

She had called psych and regular physician re the situation prior to calling ambulance from friends' house, so she was not using the ER inappropriately in her humble opinion... inside she was thinking stroke? brother had had two strokes when he was 48 ish (due to head trauma x3 one year apart)

waiting in triage she gets suddenly super duzzy (spots and dizziness is in the head not around her) has to sit, numbness increased to R hand ... speech sounds like tongue is swollen (it's not) - BP 188/104 ish... dizziness subsides... while sitting numbness to L hand and a little up arms...

PH hypothyroid, hypertension, takes ASA for prevention (just because she can), bipolar, hypoglycemia (gs 101, had eaten breakfast)

you know what I am going to ask, what would be your expectation as far as dx tests and how you would approach this pt. Not looking for pity just wondering if you had a similar situation what would you expect for Dr.s orders and nursing intervention.

is that advice? Not a perfect presentation of the facts as I perceive them but I am up too early...

Specializes in PICU, Sedation/Radiology, PACU.

Yes, this is still medical advice. Any time you are asking questions about your own health conditions, it is medical advice and against the Terms of Service here. Please direct you questions toward your doctor and if you are my satisfied with his/her care, dot hesitate to get a second opinion. Good luck.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

That's still asking for medical advice. I'm sorry you aren't feeling well these symptoms can be from meds to hyperventilation.

I hope you feel better:hug:.

Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

Closing thread per Terms of Service (TOS). Best of luck to you, Liddle Noodnik.

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