Case Scenario You are the school nurse where Mrs. T. works. While at recess duty, another teacher runs up to you and reports that Mrs. T. is not acting like herself. When you approach, you see her sitting on a bench mumbling something to the kids gathered around her. She has dropped her cell phone on the ground, and her right arm appears limp. You try asking her questions and you notice the right side of her face is slacken, and she does not seem to be making sense when talking. You call an ambulance, and try to walk her back to your office, but she does not move well. You reassure her and try to determine if anything occurred prior to her loss of speech and movement. The other teachers say it came on suddenly, within the last 5 minutes. Mrs. T. shakes her head no to pain.

Case Study Mrs. T. The acute episode Mrs. T. experienced at work presents as a sudden onset of rightsided weakness, facial droop, and speech impairment—classic signs of a stroke. Her risk factors for stroke include uncontrolled hypertension (BP 184/92), hypercholesterolemia (elevated cholesterol and triglycerides), smoking, and possibly her birth control pill usage, which can increase the risk of blood clots. The positive FAST & VAN score and NIHSS of 12 further indicate a severe stroke. The normal CT head rules out hemorrhage but does not dismiss the possibility of an ischemic stroke, which might not show immediately on imaging. The INR of 0.7 might suggest a potential bleeding risk, possibly due to the use of Pravastatin or interactions with other medications. The weight gain, unhealthy lifestyle habits (smoking, alcohol consumption, fast food), and lack of regular exercise contribute to her risk factors for cardiovascular diseases. In this scenario, immediate attention is crucial. Mrs. T. needs prompt intervention to restore blood flow to her brain. Thrombolytic therapy might be considered if not contraindicated due to her recent normal CT findings, but consultation with a neurologist is imperative. A comprehensive evaluation of her medication regimen is necessary to ensure no adverse interactions or contraindications between her current medications and any new interventions. Finally, Mrs. T.'s presentation aligns with an acute ischemic stroke, demanding immediate medical attention, and comprehensive management to mitigate risk factors and promote recovery.