Nursing care of stroke patients with atrial fibrillation : 2 case studies.

Abstract

     This comparative case study of two patients aimed to examine nursing care for stroke patients with atrial fibrillation and to develop efficient and standardized care guidelines. The study involved two stroke patients with atrial fibrillation who were admitted to the Stroke Unit at Khon Kaen Hospital between April and September 2025. Data collection tools included medical record reviews, patient interviews, and observations. A health assessment utilized Gordon's 11 Functional Health Patterns to establish nursing diagnoses. Orem's Self-Care Theory was applied in patient care.

     Results: Case study 1 involved a Thai female with left-sided limb weakness and slurred speech for 2 hours. She was referred from Mancha Khiri Hospital and had a history of asthma. The physician diagnosed acute cerebral infarction with an NIHSS score of 18. EKG revealed atrial fibrillation. The patient received rt-PA thrombolytic therapy. Nursing care addressed 7 problems: risk of increased intracranial pressure, risk of inadequate cerebral tissue oxygenation, risk of bleeding, fluid and electrolyte imbalance, risk of inadequate nutrition, patient and family anxiety, and self-care deficit. The patient experienced no complications. She was hospitalized for 8 days and was transferred back to a local hospital. Case study 2 involved a Thai female with right-sided limb weakness and an inability to speak for 1 hour. She was referred from Ban Fang Hospital and had no underlying diseases. The physician diagnosed acute cerebral infarction with an NIHSS score of 31. EKG revealed atrial fibrillation. The patient required mechanical ventilation and mechanical thrombectomy. Nursing care addressed 8 problems, including an additional risk of post-procedural complications. The patient experienced no severe complications, was hospitalized for 14 days, and was transferred back to a local hospital.