Nursing Care of Thrombolytic Therapy for Stroke

Written by Zhang Hui
Neurology
Updated on December 21, 2024
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Thrombolytic therapy for stroke is an important tool in the treatment of cerebral thrombosis. If administered within the thrombolytic time window, which is currently within four and a half hours from onset, intravenous thrombolytic treatment can significantly save lives and improve the quality of life for patients. Post-thrombolysis care is also crucial, as there are some complications associated with thrombolytic therapy. It is essential to strictly monitor blood pressure after thrombolysis; typically, blood pressure should be checked every 15 minutes, as high blood pressure can significantly increase the tendency for bleeding. During the care process, it is also important to monitor for signs of bleeding such as nosebleeds, bleeding gums, the appearance of petechiae or ecchymosis on the skin and mucous membranes, and any bleeding in the urinary system. Additionally, changes in the patient’s consciousness and limb mobility should be noted. If the patient experiences worsening paralysis or significant headaches, a cranial CT scan must be promptly revisited. In summary, the nursing care following stroke thrombolytic treatment primarily involves monitoring blood pressure, watching for signs of bleeding, and observing changes in limb mobility and consciousness.

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Written by Tang Ying
Physical Medicine and Rehabilitation
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Principles of Stroke Rehabilitation Treatment

Principles of stroke rehabilitation treatment. First is the issue of timing; it is crucial to choose the appropriate time for rehabilitation intervention. Rehabilitation treatment should start as early as possible when the patient's condition is stable. Secondly, rehabilitation assessment, also known as rehabilitation evaluation, should be performed throughout the treatment process. This allows for comparability before and after treatment, clarifying the treatment results for the patient and determining if there is a need to modify the treatment plan during the process. Thirdly, it is essential to have rehabilitation treatment goals and plans. Based on assessments, short-term and long-term rehabilitation plans must be developed for the patient to achieve certain rehabilitation objectives. Fourth, the principle of gradual progression must be adhered to in rehabilitation treatment. It should not be rushed, and active participation from both the patient and their family members is crucial, incorporating daily life and exercise opportunities. Fifth, rehabilitation treatment primarily involves comprehensive therapy, which includes physical exercise, speech therapy, occupational therapy, physiotherapy, and traditional rehabilitation treatments such as acupuncture and moxibustion, as well as psychological therapy, rehabilitation engineering, and assistive devices. Sixth, conventional pharmacological treatments and necessary surgical interventions are involved. These include essential medications that must be used, and when rehabilitation methods alone cannot restore function, appropriate medical advice from relevant departments should be considered, and surgical treatment may be needed to assist the patient in better recovery.

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Written by Zhang Hui
Neurology
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What does stroke include?

Stroke, translated from the English word "stroke," refers to rapidly occurring pathological changes. Stroke mainly includes two types of diseases: ischemic cerebrovascular disease and hemorrhagic cerebrovascular disease, with ischemic cerebrovascular disease being the most common. Ischemic cerebrovascular disease includes large artery atherosclerotic cerebral infarction, small artery occlusive cerebral infarction, as well as cardiogenic cerebral embolism and other causes of cerebral infarction. Hemorrhagic cerebrovascular disease mainly includes cerebral hemorrhage caused by hypertension, subarachnoid hemorrhage, and cerebral hemorrhage caused by aneurysms or vascular malformations. The onset of a stroke is very aggressive and can severely threaten the patient's health. Once a stroke is suspected, it is critical to rush to the hospital for appropriate diagnostic tests to confirm the diagnosis and provide the most suitable treatment plan.

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Written by Tang Ying
Physical Medicine and Rehabilitation
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Rehabilitation Treatment Plan for Stroke

The rehabilitation treatment plan for stroke involves rehabilitation physicians and therapists who, through comprehensive assessment of the patient's overall medical condition and functional impairments, develop individualized plans. These plans focus primarily on the patient's functional impairments, and accordingly, design treatments for movement, speech, swallowing, and attention to promote the patient's overall rehabilitation and improve their ability to perform daily activities independently. Common rehabilitation treatment options include not only medication but also occupational therapy, speech therapy, physical therapy, psychological support, and traditional rehabilitation methods. Through these personalized and comprehensive rehabilitation treatments, the aim is to facilitate the patient's early recovery, allowing them to return to their family and work environment sooner.

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Written by Zhang Hui
Neurology
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Post-stroke depression

Recent studies have confirmed that in addition to language dysfunction, cognitive impairment, and motor dysfunction, stroke patients also exhibit many signs of depression. According to guidelines published in China in 2016, about 33% of stroke patients experience post-stroke depression, which is a very high proportion. The main symptoms of post-stroke depression include a lack of interest in anything, unwillingness to communicate with others, being quiet and reticent, non-compliance with medication, and non-cooperation with rehabilitation training. Post-stroke depression significantly affects the recovery of patients and their future quality of life. Some patients may even turn to suicide due to depression. Therefore, it is crucial to pay attention to depression after a stroke, as the incidence rate of post-stroke depression is very high, reaching up to 33%. Clinicians must carefully identify it, and family members of patients must be attentive in their care.

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Written by Zhang Hui
Neurology
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Six Common Manifestations of Stroke

Firstly, patients may experience language impairment, primarily characterized by unclear speech or sensory aphasia, where they cannot understand others' conversations. Secondly, motor dysfunction is also a very common symptom, typically presenting as hemiplegia on one side of the body. Thirdly, sensory dysfunction can occur, manifested as numbness in one side of the body, an inability to feel pain, and an inability to sense temperature. Fourthly, there may be signs of ataxia, such as unstable walking or standing. Fifthly, there may be difficulties in swallowing, coughing while drinking water, and articulation disorders. Lastly, cognitive dysfunction can also occur, characterized by slow responsiveness and similar symptoms.