Judgement call?

[nurse54361]

Hello again everyone! 
 

A pre-thank you to all that reply. I am just questioning my nursing judgment lately and haven’t been having a lot of confidence in my judgment calls. This recent one though has me questioning if it was another nurse who was taking care of the patient, would they have caught it sooner? 
 

Anyways, I had a patient post CABG who was very stable throughout the night. Vitals were great, HR in NSR. She was doing good and on her way home the next day. When I got report on her, the day nurse told me she had a headache during the day so they got PRN Tylenol which seemed to relieve her headache. Around 2 am she called me in and said she was having an 8/10 headache. I thought it was pretty high and she had a history of a stoke so I took her vitals, they were normal and then gave her the Tylenol. Around 4 I checked back in with her to do my last assessment of the night and to see how her headache was. She said her headache was relieved and I did a full head to toe and checked her sites and vitals. No change from earlier in the shift. She calls me in again around 5 in the morning and complains of pins and needles at the top of her head and I noticed slurred speech. I did a quick neuro check and she had obvious left sided deficits. So I called a code stroke. They did a whole work up and she was negative for a brain bleed, they were just thinking a TIA. 
 

The thing I’m questioning myself on is the headache. Should I have been more worried, even though she reported it relived with Tylenol and vitals were stable? Thanks for any input honestly I’m just trying to learn because I’ve been questioning my judgement a lot recently and I feel like I should be more confident since I’ve been a nurse for 2 years.  Thanks again ?

[beesnest]

I would have done the same, You did an amazing job.

[rn&run]

You did great! You assessed, treated, reassessed, and called for assistance appropriately.  I’m sorry you’re feeling down on yourself, but you needn’t.

[Guest219794]

Good work.

You aren't clairevoyant, just a heads up nurse.

[CalicoKitty, BSN, MSN, RN]

Sounds like all the right things. I would have let the doc know about 8/10 headache, but probably just an FYI notification. The concern with TIA is there is a high risk of a 'real' stroke in the next 2 weeks or so.

[JBMmom, MSN, NP]

I don't think I would have done anything differently myself. If tylenol relieved her headache there would have been no reason for additional action at that time. I don't think you have any reason to be second guessing yourself in this scenario.