In this Case Study Assignment, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.

Assessment neurological symptoms – Case Study Assignment | NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning | Walden University.

Subjective: A 70-year old woman complains about forgetfulness, which began a year earlier and is getting worse. She says that sometimes she forgets to tell you what she’s going to do once she enters another room. She is a forgetful person, and her family noticed this. However, she still manages her finances well and drives.

Objective: Vital signs: Blood pressure 130/80 mmHg, pulse 72 beats per minute, respiratory rate 16 breaths per minute, temperature 98.6°F. Physical examination: The patient appears alert, oriented, and aware of time, place and person. The cranial nerves II to XII appear intact. Sensory and Motor functions are normal. No focal neurological deficits. Diagnostic tests: CBC & BMP within normal ranges. MRI of the brain revealed mild hippocampal atrophies. Assessing the patient’s complaint: She has complained of increasing forgetfulness for over a year. Given her age and mild hippocampal atrophy, the patient may have Alzheimer’s disease. Other possible conditions to consider in a differential diagnosis are vascular dementia, Parkinson’s disease, depression, and medication side effects. Plan: Refer the patients to a neurologist for additional evaluation and management. In addition, it is important to perform a neuropsychological test in order to evaluate cognitive function. Alzheimer’s disease medications and/or cholinesterase inhibitors may be prescribed if the diagnosis is confirmed. The patient’s family and friends should also receive support and counseling. Monitor the progress of your patient and her response to treatment by following up.

References:

1. Hänninen T, Hallikainen I, Tuomainen S, et al. Prevalence and severity of mild cognitive impairment in older subjects: A population-based survey. Acta Neurol Scand. 2002;106(3):148-154. doi: 10.1034/j.1600-0404.2002.01252.x
2. Jack CR Jr, Petersen RC, Xu YC, et al. Predictions of AD based on MRI hippocampal volumes in mild cognitive impairment. Neurology. 1999;52(7):1397-1403. doi: 10.1212/wnl.52.7.1397
3. Petersen RC. Mild Cognitive Impairment as a Diagnostic Entity J Intern Med. 2004;256(3):183-194. doi: 10.1111/j.1365-2796.2004.01388.x