How to Answer James Year African Questions (Complete Guide)
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What This Question Is About
This question relates to james year african and requires a structured academic response.
How to Approach This Question
Break the problem into smaller parts and analyze each logically.
Key Explanation
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Original Question
James is a 70 year old African American male, weighing 280lbs, and a lifetime tobacco user. He was admitted to the ER for a potential stroke and has partial paralysis on his left side and is unable to talk. His blood pressure is 190/110 and the CT confirms a recent stroke. Tests also revealed that James has atrial fibrillation and heart failure. During his stay, James was given Retavase/reteplase, bumetanide/Bumex, heparin, Coumadin/warfarin, and Prinivil/lisinopril. Upon discharge, he is prescribed Prinivil/lisinopril, Coumadin/warfarin, Cardizem/diltiazem, and furosemide/Lasix. 3 months later, James comes back to the hospital feeling fatigued, weak, and has had bright red blood in his stool the last few days. Tests reveal he has an INR of 5.6. 1. Given his risk factors, what may have contributed to James’ stroke? 2. What is the rationale behind each medication James was prescribed, in the hospital and upon discharge? 3. From the medications he was taken, what type of stroke did James have? 4. Why was James give warfarin AND heparin while he was in the hospital? 5. What lab values for warfarin and heparin need to be monitored? 6. What education would you give James about taking warfarin? (consider lifestyle changes/factors/precautions) 7. What pain medications should James avoid and why? (ie: clotting) 8. What lifestyle changes would you recommend to him? 9. Explain the INR levels 3 months post initial discharge and why that is concerning. 10. Discuss any medications that should be given at this point and why? (ie: clotting)
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