Nursing management: Stroke

Nursing management: Stroke

  • Stroke survivorship and coping
    • Stroke support groups within rehab facilities and community are helpful
      • Mutual sharing
      • Teaching
      • Coping
      • Understanding

Nursing diagnoses

  • Decreased intracranial adaptive capacity related to decreased cerebral perfusion pressure of ≤50 to 60 mm Hg and sustained increase in ICP secondary to thrombus, embolus, or hemorrhage
  • Risk for aspiration related to decreased level of consciousness and decreased or absent gag and swallowing reflexes
  • Impaired physical mobility related to neuromuscular and cognitive impairment and decreased muscle strength and control
  • Impaired verbal communication related to aphasia
  • Unilateral neglect related to visual ield cut and loss on one side of body (hemianopsia) and brain injury from cerebrovascular problems
  • Impaired swallowing related to weakness or paralysis of affected muscles
  • Situational low self-esteem related to actual or perceived loss of function and altered body image

Planning

  • Typical goals are that the patient will
    • Maintain a stable or improved level of consciousness
    • Attain maximum physical functioning
    • Attain maximum self-care abilities and skills
    • Maintain stable body functions (e.g., bladder control)
    • Maximize communication abilities
    • Maintain adequate nutrition
    • Avoid complications of stroke
    • Maintain effective personal and family coping