Nursing care of ischemic stroke patients who are unconscious using the expressway system : a case study

Abstract

     This case study aims to study nursing care for ischemic stroke patients who are unconscious and admitted to the expressway system so that the patients can receive blood clot-dissolving drugs in time. The study was based on retrospective data collection from patients' medical records. Select 1 specific case from a patient diagnosed with a stroke who came to the hospital outside of business hours for no more than 4.5 hours, called on October 24, 2023 at 8:31 p.m. A 54-year-old male patient was admitted with convulsions, eye twitching, blurred vision, foaming at the mouth, vomiting, and weakness in his right limb. Symptoms began at 8:00 p.m. The wife called 1669 and the emergency vehicle at Pak Chong Nana Hospital came out to receive medical treatment before reaching the hospital. There was an initial evaluation and he was brought back to the emergency room to determine that he met the criteria for acute stroke. Upon arrival at the hospital, the doctor assessed the acute stroke score as 18 points. Neurological evaluation: The patient does not open his eyes, does not speak, his right limb is weak and has no movement. The left limb can be lifted with little resistance and is cyanotic. The doctor considered intubating the patient and sent for a computerized tomography (CT) diagnosis. It was found that there was acute brain death. and consulted a neurologist at Maharat Nakhon Ratchasima Hospital. Treatment was given with blood clot-dissolving drugs at the emergency room. Nursing problems in the crisis period 1). Brain tissue does not receive enough oxygen due to reduced blood flow in the brain. 2). Risk of easy bleeding due to receiving blood clot-dissolving drugs. 3). Relatives are worried about illness. After providing nursing care according to the nursing plan that was laid out the patient opens his eyes when called. Not following orders, the right limb can move at level 5. The left limb can be raised against force. Breathing is related to the ventilator. No cyanosis No bleeding from the body and provide nursing care while being transferred for treatment at the Intensive Care Unit at Pak Chong Nana Hospital