Nursing care for patients with acute ischemic stroke who enter the stroke fast track system at Kalasin hospital : 2 case studies.

Abstract

     This study was case study aimed to 1) examine the nursing care of patients with acute ischemic stroke who enter the stroke fast track system and receive or do not receive treatment with rt-PA thrombolytic drugs. 2) Use the study results to develop and emphasize the importance of using the stroke fast track when experiencing stroke symptoms so that more patients can quickly access the fast track system. By comparing the nursing care of patients with acute ischemic stroke who entered the stroke fast track system, both those who received and did not receive treatment with rt-PA thrombolytic therapy in the critical care stroke unit of Kalasin Hospital between June and July 2024, a total of 2 cases. The tools used in the study included Data collection forms were used to gather information from patient medical records, interviews, and observations. The data were analyzed and compared, and nursing care plans were developed using the standards for nursing care for stroke patients.

     Study results comparing the nursing care of patients with acute ischemic stroke who entered the stroke fast track system, both those who received and did not receive rt-PA thrombolytic therapy. Case Study 1: A 79-year-old Thai male patient presented with significant symptoms of lethargy and inability to speak, which occurred one hour before arriving at the hospital. Came by ambulance. He has a medical history of type II DM, HT, DLD, and CKD. Taking medications regularly, the doctor diagnosed an Acute cerebral infarction, assessed with an NIHSS score of 6 points, and thus received treatment with thrombolytic drugs. The patient had no complications. On the day of discharge, the patient showed no signs of weakness and was able to perform daily activities. Case study 2: A 63-year-old Thai woman with the main symptoms of slurred speech and left-sided weakness. It occurred 2 hours and 30 minutes before coming to the hospital. came by private car. The patient denied any underlying diseases. The doctor diagnosed an Acute cerebral infarction and assessed the NIHSS score at 2 points, so she did not receive rt-PA thrombolytic therapy but received Antiplatelet drug post symptom occur after 48 hrs. On the day of discharge, the patient still had minor left-sided weakness but was able to perform daily activities.