Nursing Care for Stroke Patients at Somdet Hospital, Kalasin Province: Case Study of 2 Patients.

Abstract

     This is a case study investigating and comparing the nursing care of two stroke patients admitted to Somdet Hospital. Data collection tools included medical record reviews, family interviews, and direct observation. The data were analyzed to compare risk factors for stroke, pathophysiology, signs and symptoms, medical treatments, nursing problems and diagnoses, and discharge planning with continuity of care.

     Study Findings: Case Study 1: A 70-year-old Thai male presented with an unsteady gait, left-sided limb weakness, and dysarthria, occurring one hour prior to hospital arrival. Upon admission, he was conscious and alert. His medical history included chronic alcohol consumption, smoking, hypertension, and dyslipidemia. He reported poor medication adherence, having discontinued his antihypertensive and lipid-lowering medications four years prior. He was diagnosed with acute ischemic stroke and received prompt management via the Stroke Fast Track protocol. Nursing care was provided according to the physician's treatment plan and the patient's specific needs, leading to recovery and discharge planning. Interdisciplinary team collaboration was initiated for home visits and follow-up in the community.

            Case Study 2: A 63-year-old Thai male presented with generalized seizures and lethargy, unresponsive to verbal stimuli for 30 minutes prior to hospital arrival. He had a history of chronic alcohol consumption, diabetes mellitus, muscle cancer, and thyroid disease. He had experienced two previous ischemic strokes in 2022. Upon admission, the physician initially diagnosed hypoglycemia. Subsequently, the patient remained lethargic but arousable, with left-sided limb weakness and no verbal response. An acute right-sided intracranial hemorrhage was identified in the midbrain. The final diagnoses were cerebral infarction and respiratory failure. The patient received intravenous thrombolytic therapy (rt-PA) and was transferred to Srinagarind Hospital for further management.