Acute Ischemic Stroke: Current Management and Role of the Nurse Practitioner |
Ji-Yeon Kang, Patricia Coleman, Keum-Soon Kim, Young-Hee Yi, Eun-Jung Choi |
1Department of Nursing, Dong-A University 2School of Nursing, University of Rochester 3College of Nursing, Seoul National University 4Graduate School of Clinical Nursing Science, Sungkyunkwan University 5Department of Nursing, Dong-A University |
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Abstract |
Purpose This paper reviews current diagnostic evaluation, treatment, nursing considerations, and the nurse practitioner’s (NP) role in acute ischemic stroke care. Methods National guidelines and extensive literature on acute stroke care were reviewed and a relevant clinical case was introduced. Results Computerized tomography (CT) of the head without contrast is the initial brain imaging procedure for patients with an acute stroke. Magnetic resonance imaging (MRI) can be an alternative test. Restoration of cerebral perfusion to the affected area is a key therapeutic strategy for ischemic stroke. A number of treatment strategies such as thrombolysis, anticoagulation, antiplatelet, and surgical treatment can be selected to improve blood flow to the ischemic region. The NP on the stroke team is involved with immediate stroke management including neurological assessment, ensuring adequate oxygenation, blood pressure management, activity, and diet. Discharge planning with the patient, family teaching and coordination of follow up care should also be implemented early in the hospitalization. Conclusion The nurse practitioner is one of the cardinal members on the stroke team, and must be updated with current treatment and management guidelines. |
Key Words:
Stroke, Nurse practitioner, Role |
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