Nursing Care of Acute Ischemic Stroke with Intravenous Thrombolysis and Mechanical Thrombectomy: A Case Study

Abstract

Background: A stroke is a neurological disease in which the brain loses blood to nourish from narrowed or ruptured cerebral arteries. As a result, brain cells die, which can cause disability or death. Currently accepted treatment guidelines include intravenous thrombolytic drugs in ischemic strokes. Mechanical thrombectomy to remove blood clots within 6 hours and craniotomy to reduce intracranial pressure in patients with cerebral edema within 48 hours can reduce mortality and disability. This article presents a case study with the aim of studying the nursing of patients with acute stroke receiving intravenous thrombolysis and mechanical thrombectomy

Methods: This study was a patient admitted to an intensive care unit with a stroke. Institute of Neurology, 1 case for a period of 5 days from the collection of patient information from medical records in the form of nursing records. Doctor's treatment, interviews with patients and relatives. Observe, analyze comparative data, and plan the nursing process in the form of Focus Charting and monitor changes including distribution planning

Results: It was found that this patient had a history of diabetes and high blood pressure, which are the main causes of stroke. The patient was treated with intravenous thrombolysis and mechanical thrombectomy procedure to remove the blood clots. After treatment, the patient improved. The patient improved in order, 18 points on the NIHSS, 5 points on the modified Rankin scale (mRS), and 2 points on the Barthel index. Use of critical nursing practices in the acute phase that are still pending for referral. Distribution Planning As follows: 1) Intracranial pressure control, 2) Oxygen therapy, 3) Blood sugar level management, 4) Activities of Daily Living support. Institute of Neurology, 5 days in total

Conclusion: This patient was treated with intravenous thrombolysis and mechanical thrombectomy procedure to remove the blood clot. After treatment, the patient began to improve without complications. Enter a physical therapist's rehabilitation program. Therefore, the medical team coordinated to send the patient back for further treatment according to the original rights and made an appointment to monitor the symptoms 4 weeks before discharge. It can be seen that if the patient is cared for in a critical stage by a multidisciplinary team. In particular, registered nurses who are competent to care for patients in critical stages according to nursing standards, including holistic patient nursing, have resulted in good clinical results to reduce the mortality rate and reduce the disability of patients.