Nursing care of patients after hemorrhagic stroke

Abstract

In the world today, cerebral stroke is considered to be the third most common cause of death and the first cause of disability. In Poland it accounts for approximately 60,000 cases of stroke. Hemorrhagic stroke is characterized by higher severity resulting in high disability or even death of a patient. The aim of this paper was to identify the problems of nursing-caring work, present actions that should be taken to effectively address the problems, and to show the ways to prevent the most common complications after stroke incident. The method of individual case was applied to develop a nursing process in a patient 10 days after the episode of hemorrhagic stroke along with the following research tools: author’s questionnaire, Barthel self-care rating scale, Norton scale for assessing risk for pressure ulcers, Glasgow coma scale and the Beck Depression Inventory. The conditions diagnosed in the patient were a consequence of abnormal blood pressure, self-care deficit, improper diet and bad mental condition. The risk of developing complications associated with prolonged immobility such as bed sores, swelling of the extremities affected by paresis, contractures, deep vein thrombosis, pneumonia, increased intracranial pressure and urinary tract infections, as well as the risk of recurrent hemorrhagic stroke as a result of chronic hypertension was assessed. In this case study, hemorrhage occurred in areas that are most common for hemorrhagic strokes. However, it did not proceed in a typical way as a patient remained fully conscious. The patient received conservative treatment at the neurology department. Properly implemented process of treatment and care helped to avoid a number of serious complications occurring after stroke (patient observed only problems with the bowel discharge). Measures taken by a nurse provided the patient with a feeling of security and allowed for a holistic approach and addressed his problems.