Role of Nursing Personnel : Stroke

Role of Nursing Personnel

  • Assess clinical manifestations of stroke and determine when clinical manifestations started.
  • Screen patient for contraindications for tissue plasminogen activator (tPA) therapy.
  • Infuse tPA for patients with ischemic stroke who meet the criteria for tPA administration.
  • Assess respiratory status and initiate needed actions such as O2, oropharyngeal or nasopharyngeal airways, suctioning, and patient positioning to prevent aspiration, obstruction, and atelectasis.
  • Assess neurologic status, including intracranial pressure (ICP), if needed.
  • Monitor cardiovascular status, including hemodynamic monitoring, if needed.
  • Assess patient’s ability to swallow (in conjunction with the speech therapist).

Licensed practical/vocational nurse (LPN/LVN)

  • Administer scheduled anticoagulant and antiplatelet medications

Unlicensed Assistive Personnel

  • Obtain vital signs frequently and report these to RN.
  • Measure and record urine output.
  • Assist with positioning patient and turning patient at least every 2 hr (as directed by RN).
  • Perform passive and active range-of-motion exercises (after being trained and evaluated in these procedures).
  • Place equipment needed for seizure precautions in patient room

Role of Other Team members

Speech therapy

  • Assess swallowing reflex.
  • Evaluate patient for communication defects (e.g., aphasia).

Physical therapy

  • Position patient in a functional position.
  • Assess function and together with patient, plan a rehabilitation program.