Nursing care of Ischemic Stroke patients in the Intermediate care at Kalasin Hospital : A Study.

Abstract

      This study compared two purposive case studies of patients with ischemic or occlusive stroke who were admitted to Kalasin Hospital between July 2025 and December 2025. The study utilized Gordon's 11 health patterns framework and Orem's self-care theory, employing problem identification, nursing intervention planning, and continuous assessment of nursing outcomes.

      Results :

      Case Study 1 : A 68-year-old Thai male patient presented with weakness in the left arm and leg. The diagnosis was Acute Cerebral Inflammation S/P Craniectomy. His past medical history included brain surgery for cerebral hemorrhage with seizures. He was admitted to Kalasin Hospital. The treatment plan included medication, physical rehabilitation, blood pressure control, and physiotherapy. After continuous follow-up, his Glasgow Coma Scale (GCS) reading was E4V5M6. He continued to experience weakness in the left arm and leg. Left motor power was grade II, right motor power was grade V. Complications included hypertension, impaired movement, risk of aspiration, and impaired self-care abilities (ADL=10, MRS=5). He lacked a primary caregiver and faced economic difficulties after the illness. Following treatment, he received continuous care from a multidisciplinary team, and his condition improved progressively.

      Case Study 2 : An 81-year-old Thai female patient presented with right-sided weakness, facial asymmetry, and slurred speech. The diagnosis was Acute Cerebral Inflammation due to MCA Thrombosis. Her past medical history included cardiac arrhythmias and hypertension. The patient was admitted to Kalasin Hospital and discharged home for continued rehabilitation. The patient had a Glasgow Coma Scale (GCS) of E4V2M5, with continued weakness in the right arm and leg, facial drooping, and right-sided motor power grade II, while the left-sided motor power was grade IV. The patient received medication and rehabilitation. Hypertension and cardiac arrhythmias were observed, along with decreased mobility and self-care abilities (ADL=30, MRS=4). The patient had difficulty swallowing and received tube feeding. Following treatment and rehabilitation, the patient's overall condition improved progressively.