What is included in nursing care of patients with vertebrobasilar stroke?

Updated: Mar 03, 2020
  • Author: Vladimir Kaye, MD; Chief Editor: Stephen Kishner, MD, MHA  more...
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Answer

Answer

A wide variation in symptoms may be seen with stroke, depending on the severity of the brain damage. Initial nursing intervention involves maintaining skin integrity, establishing a bowel and bladder program, maintaining nutrition, and ensuring the person's safety from injury.

Other important nursing issues include communication with the treating clinician in order to initiate therapy services for the assessment of ambulation, transfers, swallowing function, and the performance of activities of daily living (ADL). In some patients, the severity of the deficits makes ambulation impossible; however, patients should be mobilized out of bed and should be actively involved in physical and occupational therapy.

Positioning in bed and in a chair assures the patient's comfort and prevents complications from skin breakdown. If the upper extremity is flaccid or paretic, positioning is critical to the prevention of shoulder subluxation and pain from shoulder-hand syndrome.

Nursing staff always should involve family members in the care of a person who has sustained a stroke. The patient and family members may be unfamiliar with stroke and its effects. Education must be provided to make the patient and his/her family members aware of the importance of continuing with activities, of appropriate precautions, and of continuing therapy upon discharge to home.

Some patients have fluctuating symptoms and signs, which often are related to position. Because of this possibility, precautions are necessary with activities that can be undertaken until the symptoms have stabilized.

Physical therapy (PT) and occupational therapy (OT) should be initiated soon after admission, depending on the condition of the patient. Once the symptoms have stabilized, patients should be mobilized out of bed, which will allow them to participate in full PT and OT activities.


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