Question

Penny Williams, a 74-year-old patient, is admitted to the telemetry unit with the diagnosis of acute ischemic stroke. The patient is experiencing paroxysmal atrial fibrillation with a controlled ventricular rate on the monitor. The CT of the head without contrast reveals no evidence of hemorrhage. The transesophageal echocardiogram reveals moderate mitral valve insufficiency and embolism as a primary cause of the stroke. The patient is on a weight-based heparin protocol. The patient received digitalis to keep the ventricular rate of the atrial fibrillation controlled. The patient has right-sided paralysis and global aphasia. The patient has unilateral neglect of her right side and has right field homonymous hemianopsia. There is papilla edema present bilaterally. The patient is drooling from the right side of her mouth and coughs periodically. The patient was found by her daughter after her daughter had gotten out of work and arrived at her mother’s home. The daughter stated her mother was normal before she left for work, and 10 hours later the mother exhibited the symptoms described above. The time of onset for the stroke could not be safely determined so no interventions could be used to treat the stroke. What principles of nursing management should the nurse provide the patient during the acute stage of the ischemic stroke based on the assessment findings from the case study? Place the assessment findings that are supported by the nursing principle(s) in parenthe

Answer 1

Acute phase of ischemic stroke can be managed by the nurse on the following way

• Asses the patients vital parameters, GCS frequently this can help to identify and prevent major complications and provide right time intervention (principles of preventing and managing complications )
• The patient can be continued for her cardiovascular drugs and monitored for the pulse rate to assess the changes ninth heart rhythm or a raise in blood pressure
• The level of consciousness, orientation ,ICP to be assessed because there are chances the patient may have increased ICP causing papilla edema.
• Communicate with the patient and daughter in regards to the care and its prognosis.Interpret and inform any changes noted to the provider to work as a interdisciplinary team (principles of good communication in nursing practice)
• Privide personal hygienic care and attend the basic needs of daily activities .Respect the patient though not able to communicate verbally due to global aphasia,but they can give expression to their feelings (principal of dignity and respect in nursing and treating everyone equally.
• Assess the patients individualised needs like (regaining to speak,vision challenges and management(principles of staying updated in the field of nursing )