Nursing Care of Cerebrovascular Accident with Thrombolytic Drug and Mechanical Thrombectomy: A Case Study

Abstract

Introduction: A cerebrovascular disease is a disorder of the nervous and cerebrovascular system which can cause some parts of the whole brain to malfunction leading to disability or death. Therefore, urgent care is needed, by giving thrombolytic drugs within 4.5 hours, giving aspirin within 48 hours, performing the mechanical thrombectomy intervention within 6 hours, and reducing intracranial pressure by the craniotomy operation within 48 hours which can reduce mortality and disability rates. This article presents a case study which aimed to investigate nursing care for ischemic stroke patients who received thrombolytic drugs and underwent a cerebrovascular catheterization to remove blood clots.

Methods: This study investigated a patient admitted to the stroke ward of Rajavithi Hospital for 22 days. Data were obtained from inpatient medical records, interviews with the patient and relatives, and follow-up calls.

Results: The result showed that the patient had a history of dyslipidemia and hypertension as the main causes of stroke. The patient was treated by thrombolytic anticoagulants together with mechanical thrombectomy to remove blood clots. After the patient's was able to help himself, the doctors allowed him to return home. The length of stay in the hospital was 11 days.

Conclusion: According to the study, the patient was treated with medicated with thrombolytic drugs and underwent mechanical thrombectomy. After the treatment, beginning to recover, the patient participated in the rehabilitation program supervised by physiotherapists. A 1-week follow-up was planned, and the patient was allowed to return home. The patient got better: E4V5M6 pupil 3mm, RTLBE Motor power Grade 4 right arm, Grade 5 right leg, Grade 5 left limb, Barthel Index of ADL (activity of daily living) of 75 points, and Modified Rankin Scale of 2 points. The results from the case study would be beneficial as it could be a guideline for the nursing care for stroke patients receiving thrombolytic drugs and undergoing cerebrovascular catheterization to effectively remove blood clots