Nursing care of patients after ischemic stroke – case study

Abstract

Nowadays, the number of cerebral stroke increases dangerously, which is a challenge for modern medicine. Ischemic stroke is the main cause of disability, significantly worsening the patient’s quality of life and often even leading to death. In Europe, more than 20% of patients die within the first three months after the onset of an episode of stroke, while another 20% struggle with severe disability, not allowing them to return to life before the onset. Decrease in the efficiency of the patient after stroke affects all aspects of his life. The condition of a patient after stroke requires help with the basic activities of everyday life, which is a significant burden for the patient and his family. It is necessary to reconcile with the fact of the disease and the resulting restrictions and to acquire the knowledge and skills necessary to care for the patient after a stroke. The aim of the study was to identify selected care and nursing problems and deficits of the patient after ischemic stroke and to propose actions for their effective solution. In order to develop the nursing process, an individual case method was used and the following methods were used: patient’s direct observation, history, symptoms and analysis of medical records, Glasgow coma scale, Barthel self-care scale and Norton scale for assessing risk for pressure ulcer. In the analyzed patient, the existing problems were the result of cardiovascular burden resulting from the current ischemic heart disease, hypertension and condition after myocardial infarction, as well as the deficit in the matter of self-care and depressed mood. The patient’s condition was also evaluated for re-occurrence of stroke as a result of longterm hypertension. The case studied was typical for the clinical picture of ischemic stroke. The patient was conscious, although there were slight disturbances of consciousness. Her condition was determined to be medium heavy. There was a growing neurological deficit manifested by increasing problems with speech and disturbance of balance. There were no violent symptoms characteristic of hemorrhagic stroke. The patient underwent conservative treatment in the neurological ward. Properly implemented care and treatment process allowed to avoid complications related to the occurrence of stroke that are dangerous for health and life, and the nursing interventions have resulted in an effective solution to the patient’s care problems.