A nurse in an outpatient clinic is collecting data from a client who tells the nurse, "I have pain in my legs when I begin to walk, but the pain stops when I stop walking." Which of the following conditions should the nurse suspect?

Condition the Patient is Most Likely Experiencing:

Intracerebral Haemorrhage (ICH) : The patient presents with a severe headache, lethargy, decreased level of consciousness, and slurred, incomprehensible speech, which are common signs of a stroke or intracerebral haemorrhage. A history of hypertension and atrial fibrillation increases the risk for both ischemic and hemorrhagic strokes. The use of apixaban, an anticoagulant, suggests the patient is at risk for bleeding complications, including intracerebral haemorrhage.

Interventions to Perform/Anticipate:

1. Perform a CT Scan of the Head:
   • Rationale: A CT scan will help determine if there is bleeding or an ischemic event in the brain. It is crucial for differentiating between ischemic and hemorrhagic stroke, guiding subsequent treatment.
2. Administer Intravenous Antihypertensives:
   • Rationale: Controlling blood pressure is critical to reduce the risk of further bleeding in the brain. Immediate BP management is essential in the acute setting of suspected stroke.

Parameters to Monitor:

1. Neurological Status:
   • Rationale: Monitoring changes in the patient’s level of consciousness, pupil reactions, and motor response will help assess the progression of the neurological deficit and effectiveness of interventions.
2. Blood Pressure:
   • Rationale: Maintaining blood pressure within a safe range is essential to prevent exacerbation of the hemorrhage. Hypertension management is key to avoid further complications.

A. Women often have vague symptoms of stroke such as weakness or hallucinations: While women may sometimes present with less typical symptoms, stating that hallucinations are common is misleading. Stroke symptoms in women can vary, but weakness and other neurological deficits are more common.
B. The FAST acronym stands for Face, Arms, Swallowing, and Time: This is incorrect. FAST stands for Face (drooping), Arms (weakness), Speech (difficulty), and Time (importance of quick action).
C. Stroke patients always present with dysphasia: This is incorrect. Not all stroke patients have speech difficulties; symptoms vary depending on the area of the brain affected.
D. Treatment that begins within 3 hours of symptom onset can minimize or avoid permanent loss of function: This is correct. Timely intervention, especially with treatments like tPA for ischemic strokes, can significantly reduce the extent of brain damage and improve outcomes.