![]() ![]() Sensation and perception (usually the patient has decreased awareness of pain and temperature).Mental status (memory, attention span, perception, orientation, affect, speech/language). ![]() Blood pressure maintained within normal limits.Volume of fluids ingested or administered and volume of urine excreted per 24 hours.Quality and rates of pulse and respiration ABGs, body temperature, and arterial pressure.Color of face and extremities temperature and moisture of skin.Eye opening, comparative size of pupils and pupillary reactions to light, and ocular position. ![]() Presence or absence of voluntary or involuntary movements of the extremities: muscle tone, body posture, and head position.Change in level of consciousness or responsiveness, ability to speak, and orientation.Weigh patient (used to determine medication dosages), and maintain a neurologic flow sheet to reflect the following nursing assessment parameters: Nursing Assessment During Acute Phase (1 to 3 days) Monitor for UTIs, cardiac dysrhythmias, and complications of immobility.Decreased cerebral blood flow: Pulmonary care, maintenance of a patent airway, and administration of supplemental oxygen as needed.Neurologic assessment to determine if the stroke is evolving and if other acute complications are developing.Continuous hemodynamic monitoring (the goals for blood pressure remain controversial for a patient who has not received thrombolytic therapy antihypertensive treatment may be withheld unless the systolic blood pressure exceeds mm Hg or the diastolic blood pressure exceeds 120 mm Hg).Intubation with an endotracheal tube to establish a patent airway, if necessary.Possible hemicraniectomy for increased ICP from brain edema in a very large stroke.Management of increased intracranial pressure (ICP): osmotic diuretics, maintain PaCO2 at 30 to 35 mm Hg, position to avoid hypoxia (elevate the head of bed to promote venous drainage and to lower increased ICP).Recombinant tissue plasminogen activator (tPA), unless contraindicated monitor for bleeding.Administer anticoagulant agents as prescribed (eg, lowdose aspirin therapy).Prepare and support patient through carotid endarterectomy.Help patients alter risk factors for stroke encourage patient to quit smoking, maintain a healthy weight, follow a healthy diet (including modest alcohol consumption), and exercise daily.Transthoracic or transesophageal echocardiography.History and complete physical and neurologic examination.Depression, other psychological problems: emotional lability, hostility, frustration, resentment, and lack of cooperation.Such dysfunction may be reflected in a limited attention span, difficulties in comprehension, forgetfulness, and lack of motivation. Frontal lobe damage: Learning capacity, memory, or other higher cortical intellectual functions may be impaired.Impaired Cognitive and Psychological Effects ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |