Nursing Care Of Acute Stroke Patients After Receiving rt-PA Therapy

Braimah, Janet; Kongable, Gail L.; Rapp, Karen; Daley, Sheila; Bratina, Patti; S, Sailor; Donnarumma, R; Spilker, Judith

doi:10.1097/01376517-199712000-00007

Cited by 10 publications

(11 citation statements)

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“…Table 6 summarizes nursing care associated with thrombolysis and nonthrombolysis treatment of patients with acute cerebral ischemia on the basis of the original NIH-NINDS study protocol and AHA/ASA guidelines. 2,29,[83][84][85][86] …”

Section: Emergency Nursing Interventions In the Emergency/hyperacute mentioning

confidence: 99%

“…53,134 Bleeding assessment after administration of rtPA is the responsibility of the clinical nurse, who monitors the patient for major and minor bleeding complications in the first 24 to 36 hours after administration of rtPA. 84,135 ICH is the major bleeding complication associated with thrombolytic therapy. 83,135 In the NINDS trials, 6.4% of treated patients had symptomatic ICH, which is defined as "any CT-documented hemorrhage that was temporally related to deterioration in the patient's clinical condition in the judgment of the clinical investigator" within 36 hours of treatment.…”

Section: Intensive Managementmentioning

confidence: 99%

“…The nursing staff must be prepared to administer 6 to 8 U of cryoprecipitate containing factor VIII and 6 to 8 U of platelets. 83,84 The physician will decide on further action in collaboration with other team members, such as the consulting neurosurgeon. Facilities that treat patients with thrombolytics should have a hemorrhage algorithm (Table 12) and clinical guidelines to expedite assessment and management of a new ICH.…”

Section: Intensive Managementmentioning

confidence: 99%

“…Minor bleeding complications are common, such as oozing from gums and venipuncture sites, as well as hematuria and hemoptysis. 84 Assessment of the patient's skin may identify hematomas or areas of ecchymosis or purpura. If the patient has antecubital venous access, automatic blood pressure cuffs should be used with caution to prevent formation of a hematoma in the patient's arm.…”

Section: Intensive Managementmentioning

confidence: 99%

“…If hemorrhage is suspected, the rtPA infusion should be discontinued immediately. 84 Management of ICH includes immediate physician notification and attainment of rapid brain imaging and laboratory work, including prothrombin time/international normalized ratio, activated partial thromboplastin time, fibrinogen level, complete blood count with platelets, and, if not already done, type and cross-match. The nursing staff must be prepared to administer 6 to 8 U of cryoprecipitate containing factor VIII and 6 to 8 U of platelets.…”

Section: Intensive Managementmentioning

confidence: 99%

See 4 more Smart Citations

Comprehensive Overview of Nursing and Interdisciplinary Care of the Acute Ischemic Stroke Patient

Summers¹,

Leonard²,

Wentworth³

et al. 2009

Stroke

219

208

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Section: Emergency Nursing Interventions In the Emergency/hyperacute mentioning

confidence: 99%

Section: Intensive Managementmentioning

confidence: 99%

Section: Intensive Managementmentioning

confidence: 99%

Section: Intensive Managementmentioning

confidence: 99%

Section: Intensive Managementmentioning

confidence: 99%

See 3 more Smart Citations

Comprehensive Overview of Nursing and Interdisciplinary Care of the Acute Ischemic Stroke Patient

Summers¹,

Leonard²,

Wentworth³

et al. 2009

Stroke

219

208

View full text Add to dashboard Cite

A Framework for Care During the Stroke Experience

Brauer

Schmidt

Pearson

2001

Rehabilitation Nursing

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This article describes a model we developed to guide the selection and design of nursing activities that will facilitate the health of persons with stroke and their families. Care in the context of stroke has been structured by the medical model's focus on functional ability. As a result, nursing is viewed as ancillary to other professions; yet, studies of the stroke experience from the patient's view suggest that distinctive nursing interventions are needed. Current models of illness do not sufficiently address the nature of stroke and thus cannot serve as a framework for nursing care. Our model conceptualizes stroke as a progressive, holistic experience with physiological, psychological, and social dimensions. It was developed from a synthesis of research articles identified through searches of CINAHL, MEDLINE, and PSYCHLIT (1980-1999) indexes using the terms "stroke," "stress," "coping," "chronic illness," and "transitions and growth" and from our clinical experiences. Our research established that the stroke experience involves the deterioration of the whole person and the development of a new person through discovery and resynthesis. Each of these processes progressively dominates the experience and together they form a three-phase model. This model of the stroke experience suggests that nursing care should focus initially on limiting deterioration and then concentrate on facilitating growth. Selection of specific interventions requires an understanding of the uniqueness of each stroke experience, as well as the commonalities, among these experiences.

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