I had started the discharge project on CVA stroke but it is not completed. Please complete it using the rubric and instruction. There is also a sample project from last year about diverticulitis. Please use the attached text books to assist. the patient is fictional. this is a final project and worth 20%.

Title: A Comprehensive Discharge Plan for Patients with Ischemic Stroke (CVA)

Introduction
Stroke, also known as cerebrovascular accident (CVA), is a medical emergency characterized by rapid loss of brain function caused by interruption of blood supply. Ischemic stroke, the most common type, occurs when a clot blocks an artery supplying blood to the brain. Developing a comprehensive discharge plan for patients with ischemic stroke is crucial to ensure optimal recovery and reduce the risk of future strokes. This paper aims to create a discharge plan for a fictional patient with ischemic stroke based on evidence-based interventions and guidelines.

Patient Profile
The fictional patient for this discharge project is Mr. John Smith, a 65-year-old male who was admitted to the hospital following an ischemic stroke. Mr. Smith presented with sudden onset of right-sided weakness, facial droop, and slurred speech. He has a medical history of hypertension, hyperlipidemia, and type 2 diabetes. Mr. Smith underwent thrombolytic therapy within the established time frame and has shown significant improvement during his inpatient stay.

Discharge Planning Process
Effective discharge planning for patients with ischemic stroke involves a multidisciplinary approach to address various aspects of care, including medical, nursing, rehabilitation, and social services. The process of discharge planning includes assessment, goal setting, intervention selection, and evaluation.

Assessment
During the assessment phase, the patient’s current condition, medical history, functional abilities, psychosocial factors, and support systems are evaluated. In Mr. Smith’s case, additional assessments are required, including:

1. Neurological assessment: This includes evaluating the patient’s level of consciousness, cognition, motor function, sensory perception, and communication ability. Monitoring for any signs of deterioration is crucial during this phase.

2. Functional assessment: Assessing Mr. Smith’s ability to perform activities of daily living (ADLs) such as grooming, bathing, dressing, feeding, and toileting is essential. Evaluating his mobility, balance, and transfers will help determine the level of assistance he may need upon discharge.

3. Nutritional status assessment: Identifying any dysphagia or swallowing difficulties is important to ensure that appropriate dietary modifications or referrals to a speech-language pathologist are implemented.

4. Psychosocial assessment: Assessing Mr. Smith’s mental health, emotional well-being, and coping mechanisms is crucial to identify potential risk factors for post-stroke depression or anxiety. Evaluating family dynamics and support systems is also critical.

5. Medication reconciliation: Reviewing and updating Mr. Smith’s medication list, including any new prescriptions, changes in dosage, or discontinued medications, is essential. Educating the patient and caregivers about each medication’s purpose, dosage, and potential side effects is crucial to promote adherence.

Goal Setting
Based on the assessment findings, specific goals can be set to guide the discharge plan. These goals should be focused on optimizing the patient’s functional abilities, promoting independence, preventing secondary strokes, and improving overall quality of life. Possible goals for Mr. Smith may include:

1. Improve mobility: Mr. Smith should be able to safely ambulate with or without assistive devices and perform transfers independently.

2. Enhance cognitive and communication skills: Mr. Smith should improve his ability to concentrate, recall information, and communicate effectively.

3. Promote self-care abilities: Mr. Smith should regain independence in performing ADLs, such as grooming, bathing, dressing, feeding, and toileting.

4. Optimize medication management: Mr. Smith and his caregivers should understand the importance of medication adherence and be able to manage his medications effectively.

5. Enable psychological well-being: Mr. Smith should be able to cope with the emotional and psychological effects of the stroke, with minimal risk of developing depression or anxiety.

Intervention Selection
Once the goals are identified, appropriate interventions can be selected to address each goal. The following interventions may be considered for Mr. Smith:

1. Physical therapy: A physical therapist should work with Mr. Smith to improve his strength, mobility, and balance. This may include exercises, gait training, and assistive devices as appropriate.

2. Occupational therapy: An occupational therapist can focus on helping Mr. Smith regain independence in ADLs and provide strategies for energy conservation and task modification.

3. Speech-language therapy: A speech-language pathologist can help Mr. Smith overcome any speech or swallowing difficulties through targeted interventions and exercises.

4. Medication education: A pharmacist should conduct medication counseling sessions with Mr. Smith and his caregivers to ensure understanding of medication indications, dosage, side effects, and proper administration.

5. Psychosocial support: Referrals to counseling or support groups can be made to help Mr. Smith and his caregivers cope with the emotional and psychological challenges associated with stroke.

Evaluation
Regular evaluation of the patient’s progress towards the established goals and adjustments in interventions, as needed, is crucial. Frequent follow-up visits and communication with the patient and caregivers are necessary to assess their compliance with the discharge plan, address any concerns, and make modifications as necessary to achieve the desired outcomes.

In conclusion, a comprehensive discharge plan for patients with ischemic stroke should involve a multidisciplinary approach encompassing medical, nursing, rehabilitation, and social services. Through a systematic assessment, goal setting, intervention selection, and continuous evaluation process, the plan can optimize the patient’s recovery, promote independence, and reduce the risk of future strokes. By implementing evidence-based interventions and adhering to established guidelines, healthcare providers can significantly improve the outcomes and quality of life for patients like Mr. Smith.