Nursing care for stroke Somdet hospital, Kalasin province: 2 case study.

Abstract

      This research aimed to compare the nursing care provided to two patients with acute ischemic stroke—treated via the "drip-and-ship" protocol at the Emergency Department of Somdet Hospital, Kalasin Province—specifically Case 1 (a 62-year-old male) and Case 2 (a 58-year-old male). Although both patients were treated under the same "Stroke Fast Track" system, they presented distinct differences in risk factors, disease severity, and outcomes, making them suitable subjects for identifying factors influencing nursing outcomes. A comparative case study design was employed, utilizing data from medical records, patient histories, nursing process assessments, and laboratory and radiological findings; analysis was conducted based on AHA/ASA guidelines and NIHSS scores. The study revealed that both patients were males of working age who received Alteplase within standard timeframes; however, three key differences were observed: (1) Risk factors: Case 1 had no underlying conditions, whereas Case 2 presented with overweight status, hypertension, uncontrolled gout, and a history of smoking and alcohol consumption. (2) Disease severity: Case 1 had an initial NIHSS score of 13 with no visible lesions on the CT scan, while Case 2 had an NIHSS score of 20, a large lesion in the right middle cerebral artery (MCA) territory, and concurrent renal impairment. (3) Treatment outcomes: Case 1’s NIHSS score dropped to 6, indicating good recovery, whereas Case 2 suffered from severe left-sided paralysis and loss of communication ability, necessitating a transfer for advanced care.