My first nursing job was on an orthopedic unit in a Los Angeles hospital. A large percentage of the patients admitted there had undergone hip and knee replacements. The nature of this type of surgery and the populations in which it is generally performed means that there can be significant post-operative complications. These patients are especially vulnerable in the first few days following surgery.
But I was taken by surprise when the daughter of one elderly patient, who was nearly ready to be discharged home and who had been doing remarkably well up until that morning, came running to the nurses station shouting that her mom was having a stroke. I rushed into the room, not exactly certain what to expect.
There my patient sat, in her chair, her mouth very twisted, drooling. She was having terrible difficulties with speech, but seemed mentally clear and was able to follow all instructions. Her hand grips were equal and strong, she denied having a headache, she denied any numbness or weakness anywhere and was able to take steps normally, she had no vision changes. I asked her to smile to check on the symmetry of her mouth, but she struggled to do this and was unable to despite repeated attempts. I didn’t think she was having a stroke, but clearly something WAS horribly wrong. The symptoms seemed to come on suddenly, out of the blue, and there was no progression. Her vitals were fine. I was a new nurse, and I kind of wanted to panic, but the family was all staring at me, counting on me to handle the situation professionally.
Resisting the urge to call for help at this point as I WAS the help, and before sending out the alarm, I decided to calmly ask a few more questions. The answer that sent a bell off in my head was that the symptoms exactly coincided with the insertion of her dentures. I asked her to take them out.
When she popped the top denture out we all broke out laughing. She had put her dentures in upside down! The twisting of her mouth, the inablity to speak or smile, and the drooling was due to the fight she was having to keep the dentures from falling out!
Boy, would I have been embarrassed to have sent up flares and had a doctor come in only to discover the same thing.
This is one of those patient stories you remember forever! Don’t have any idea why I was thinking of her particulary today, but just thought I would share that little story. Moral? Always take the time to evaluate a situation before panicking!