Nursing care for a stroke patient with subdural hemorrhage complicated by coagulopathy and recurrent cerebral hemorrhage: Case study.

Abstract

      This study is a case study aimed to study the nursing care of a stroke patient with subdural hemorrhage complicated by coagulopathy and recurrent cerebral hemorrhage. It was conducted on a  55-year-old Thai female with a history of dyslipidemia and prosthetic heart valve replacement taking regular anticoagulants, who presented with a severe headache and lower limb weakness. Based on physical examination and a brain computed tomography scan, she was diagnosed with subdural hemorrhage and brain edema. Following initial surgical hematoma removal, she experienced recurrent cerebral hemorrhage requiring two repeat surgeries, alongside management for increased intracranial pressure, respiratory infection, electrolyte imbalances, and anemia.

      The study revealed that major nursing problems included recurrent cerebral hemorrhage, increased intracranial pressure, anticoagulant-induced coagulopathy, respiratory tract infection, electrolyte imbalances, cardiac arrhythmias, anemia, hypoalbuminemia, and mechanical ventilation needs. Essential nursing care comprised neurological and bleeding monitoring, head-of-bed elevation, blood pressure regulation, administration of pack red cell, antibiotic administration, airway maintenance with aseptic suctioning, oxygen monitoring, and ventilator weaning preparation. Additional care involved aseptic adherence, electrolyte correction, pain management, and cardiac monitoring for arrhythmias.