Elevate the head of the bed at 30 degrees. To promote blood flow to the brain and to reduce cerebral edema. Administer osmotic diuretics as prescribed. Increased ICP can be life-threatening as it may lead to further brain damage or coma. To facilitate early detection and management of increased ICP. Observe and monitor the patient for any signs and symptoms of further increase in ICP, such as sudden headache, vomiting, and decreased alertness. To assist in creating an accurate diagnosis and monitor effectiveness of medical treatment for stroke. Nursing Interventions for Stroke Rationales Assess the patient’s vital signs and neurological status at least every 4 hours, or more frequently if there is a change in them. awake and alert) and will show orientation with persons, places, and things. Nursing Diagnosis: Ineffective Tissue Perfusion (Cerebral) related to cerebral edema and increased intracranial pressure (ICP) secondary to stroke as evidenced by drowsiness, confusion, headache, irritability, and memory problemsĭesired Outcome: The patient will re-establish effective cerebral tissue perfusion as evidenced by increased level of consciousness (i.e. Stroke CVA Nursing Diagnosis Nursing Care Plan for Stroke 1 Stereotactic radiosurgery – this procedure involves the use of highly focused radiation to correct blood vessel malformations.Surgical AVM removal – this procedure is only performed if the AVM is easily accessible in the brain.Endovascular embolization – a procedure that involves the use of coils to block the ruptured blood vessel.Surgical clipping – this procedure involves the clipping of an aneurysm to prevent it from bursting or to control the bleeding if it has already ruptured.Surgical intervention – in cases of severe bleeding, surgical procedures to evacuate the blood and repair blood vessels may be required.Anti-hypertensives – drugs to lower blood pressure. Blood transfusion – to thicken blood by improving blood volume.Use of drugs to counteract the effects of blood thinning medications.Emergency procedures includes the following:.Angioplasty and stents – the use of angioplasty balloons and stents can open a narrowed blood vessel.Ĭontrolling the bleeding is the focus of treatment in hemorrhagic stroke.This procedure carries risks especially in people with heart problems. Carotid endarterectomy – this procedure involves the removal of plaque build-up in the carotid artery.A catheter is inserted to thread into the brain and then a stent is inserted in the tube to reach the part of the brain where the clot is. Removal of the blood clot through a stent retriever – a procedure to retrieve the clot can also be performed via stent insertion.A catheter is inserted into the groin through an artery which will then thread to the brain. Administration of medications to break clots directly into the brain – medications can be administered directly into the brain through endovascular procedures.Giving the drugs intravenously allows for quicker delivery of drugs where it is needed. Administration of drugs to break up clots through intravenous injection – drugs that can dissolve clots will restore blood supply to the brain and prevent further damage.Immediate medical attention is critical to prevent permanent disability. Echocardiogram – to look for possible blood clots in the heart that could cause ischemia to blood vessels in the brain.Carotid scan – an ultrasound study of the carotid artery may be performed to observe for plaques in the arterial wall and assess the blood flow towards the brain.MRI scan – another form of brain imaging that can be done if the CT scan is inconclusive or if a more detailed image of the brain is needed. It will give detailed images of the brain that can show the presence of bleeding, ischemia, or tumor.
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