Nursing care of hemorrhagic stroke patients who received General anesthesia of craniectomy with clot removal in Kalasin Hospital : 2 Case Studies

Abstract

     This study was case study aimed to study nursing practice with hemorrhagic stroke patients who received  General anesthesia of craniectomy with clot removal and to report a comparative study of  Nursing care of hemorrhagic stroke patients who received  General anesthesia of craniectomy with clot removal , 2 cases since before , during and the post anesthesia. Collect historical data and medical treatment form medical records. Using the concept of patient assessment according to Gordon ‘s 11 health models, Orem ‘s Theory of self – Care and palliative care to find patient problems and determine nursing diagnosis to nursing planning and practice.

     Result : Case Study 1, male, 30 years old, presented with weakness in his right arm. Two hours before coming to the hospital, the patient's level of consciousness decreased. was intubated Diagnosis: Left Basal ganglion hemorrhage received surgery. Had craniectomy with clot removal surgery under general anesthesia. Surgery time is 1 hour 40 minutes. Blood loss 300 ml. Has congenital disease, HT, lack of medication and Gout, treatment is not continuous. and smoked 20 cigarettes a day for 15 years , the breathing tube can be removed, rehabilitated, supported, and given physical therapy until it can be discharged home. Continuous care Evaluate the patient's condition (Barthel Activity of Daily Living Index or ADL index) = 9/20 points, need some help, are dependent. Case Study 2, Female, 40 years old, presented with weakness in his right arm. Two hours before coming to the hospital, the patient's level of consciousness decreased. was intubated Diagnosis: Left Basal ganglion hemorrhage received surgery. Had craniectomy with clot removal surgery under general anesthesia. Surgery time is 45 minutes. Blood loss 50 ml. If you have chronic disease, HT is missing medication, after surgery you can remove the breathing tube. Weak limbs were rehabilitated and given physical therapy until they were able to be discharged home. Continuous care Evaluate the condition of patients with ADL more than 12 points, able to help themselves in daily life.