My patient had suffered a CVA otherwise known as a stroke. This is a broad term that includes a variety of disorders that influence blood flow to the brain and result in neurologic deficits. CVAs result when there is inadequate supply of blood to the brain (cerebral ischemia) or cerebral hemorrhage within the brain (Lewis, Heitkemper, and Dirksen, 2000 p. 1645). Strokes are the third leading cause of death and is the leading cause of serious, long-term disability in the United States. The risk factors for a stroke include gender, age, race, and heredity. African-Americans are more likely to suffer from a stroke, then those of another race. After the age of fifty-five, there is a greater risk of a stroke occurring. This higher incidence is also increased with hypertension. The clinical manifestations of stroke vary, depending on the area of the brain affected (Gulanick, Klopp, 1998, p. 573). The defining characteristics of altered tissue perfusion of a stroke include: headache, visual changes, dizziness, ataxia, motor deficits, and vertigo. The risk factors for an ineffective airway clearance include neurological dysfunction, obstruction, and secretions. My patient was a sixty-four year old, African-American male with a history of hypertension. The patient, S.J., had a stroke on the left side of the brain. This means that he would be most likely to suffer from right side paralysis, speech and language impairment, and a possibility of suffering from depression. The patient with a left sided stroke will also move more cautiously when transferring from the bed to a wheelchair. Due to the weakness on his right side, S.J. was on strict swallowing precautions also. This patient also had a history of diabetes, which was controlled by insulin injections daily. S.J. drank socially up until the day of his stroke. He told me that he was sitting in his chair in his home one afternoon and just "did not feel right". His...