Nursing care of hemorrhagic stroke with essential hypertension : A case study

Abstract

Abstract

            This study aimed to examine nursing care for a patient with acute hemorrhagic stroke and essential hypertension at Luang Phor Khoon Parisuttho Hospital in 2024. Data were collected from medical records and interviews with the patient and family. The analysis covered the critical, sub-critical, and recovery phases using Gordon’s 11 functional health patterns, focusing on pathology, symptoms, treatment plans, nursing diagnoses, and outcomes. The patient was a 45-year-old male with a history of untreated hypertension since 2020. He presented with sudden left-sided weakness 30 minutes prior to arrival. At the emergency department, his Glasgow Coma Scale score was E4V5M6, with slurred speech, right-side strength grade 5, and left-side strength grade 0. His pupils were reactive and equal; blood pressure was 190/110 mmHg, and blood glucose was 139 mg%. He was triaged as ESI level 2 and scored 13 on the NIH Stroke Scale. A CT scan revealed acute intraparenchymal hemorrhage with edema in the right basal ganglia. Neurosurgical consultation advised conservative management without surgery, focusing on blood pressure control (<140/90 mmHg) and monitoring for rebleeding. The patient was hospitalized for four days. This case highlights the need for nurses to be equipped with knowledge and skills in managing acute hemorrhagic stroke with hypertension to ensure patient safety, prevent complications, and reduce mortality.

Keywords :     hemorrhagic stroke, essential hypertension, Critical Nursing Care, Gordon’s Functional Health Patterns, stroke fast track system