Mrs Elena Petrova (72)

Case notes

Notes: You are the nurse in charge of the stroke rehabilitation unit at Greenbank Rehabilitation Hospital.

Patient details
  Name:            Elena Petrova
  DOB:             05/07/1952 (72 yrs)
  Address:         3 Orchard Close, Greenbank
  Admission date:  10/03/2025 (transferred from acute stroke unit, Greenbank General)
  Discharge date:  04/04/2025
  Diagnosis:       L middle cerebral artery ischaemic stroke (03/03/2025)
  GP:              Dr Michael Chen, Greenbank Family Practice

Social background
  - Lives with husband Ivan (75, fit and well, main carer)
  - Bungalow; bathroom modified (rails, shower chair) 01/04
  - Russian first language; good English pre-stroke
  - Son lives overseas — phones weekly

Medical history
  - Hypertension (poorly controlled — admits missed doses)
  - Atrial fibrillation — newly diagnosed during admission
  - Hypercholesterolaemia
  - Cataract surgery L eye (2020)

Progress during rehabilitation
  10/03  R-sided weakness (arm > leg). Expressive dysphasia. Modified diet (soft, bite-sized),
         mildly thick fluids — SLT assessment
  17/03  Walking 20 m with quad stick + 1 assist. Frustrated by speech difficulty, tearful at times
  24/03  Upgraded to normal diet, thin fluids — SLT: swallowing safe if seated upright, small sips
  28/03  Walking 50 m with quad stick, supervision only. R hand: grip weak, needs help with buttons
  02/04  Speech improving — short sentences, word-finding pauses. Mood brighter
  03/04  BP 138/84. Weight stable 64 kg. Continent

Medications on discharge
  - Apixaban 5 mg BD (new — replaces aspirin)
  - Atorvastatin 80 mg nocte (dose increased from 20 mg)
  - Ramipril 5 mg daily (new)
  - Amlodipine 5 mg daily (unchanged)
  - Dosette box arranged; husband to supervise

Follow-up
  - Community stroke team: OT, physio, SLT — 3×/week for 6 weeks (start 07/04)
  - Stroke clinic review 6 weeks
  - GP: BP check in 2 weeks; U&E 1–2 weeks after starting ramipril; monitor mood
  - Not to drive until cleared at stroke clinic

Writing task