| Abstract | CILJ: Cilj završnog rada je prikazati zbrinjavanje i skrb za bolesnika s dijagnozom akutnog ishemijskog moždanog udara kroz proves zdravstvene njege i sestrinske skrbi. U radu će se prikazati zbrinjavanje bolesnika prije i nakon postupka trombektomije te edukacija bolesnika u svrhu sprječavanja ponovljenog moždanog udara.
RASPRAVA: Bolesnik B.B., 73 godine, 19. ožujka 2023. godine dolazi u hitni prijem Kliničkog bolničkog centra (KBC) Split radi nastupa slabosti desnih udova uz smetnje govora. U hitnoj službi je učinjena kompjutorizirana tomografija (CT) kojom se ne vidi nijedan oblik intrakranijalnog krvarenja, dok se lijevo parijetalno-okcipitalno vidi hipodenzno područje koje odgovara početnoj demarkacije ishemijskog područja te se postavlja indikacija za provođenjem postupka aspiracijske trombektomije. Medicinske sestre predviđaju potrebe bolesnika, prepoznaju moguće komplikacije zahvata i održavaju sigurnost bolesnika. Tijekom postupka mehaničke trombektomije, medicinska sestra ima ključnu ulogu u procjeni prevencije, ranoj identifikaciji i praćenju eventualnih znakova neurološkog pogoršanja, primjeni proceduralnih lijekova, pravilnoj dokumentaciji postupka. Bolesnik je pri prijemu u neurološku jedinicu intenzivnog liječenja pri svijesti, hipertenzivan, žali se na bol na mjestu provedenog zahvata. Medicinska sestra je bolesnika priključila na monitor uz preporuke praćenja vitalnih funkcija. Medicinska sestra postavlja sestrinske dijagnoze i kroz proces zdravstvene njege provodi sestrinsku skrb.
ZAKLJUČAK: Cerebrovaskularni inzult, poznatiji kao moždani udar, općenito se klasificira kao ishemijski ili hemoragijski. U obje kategorije, rezultat je gubitak protoka krvi, hranjivih tvari i kisika u području mozga, što rezultira oštećenjem neurona i posljedičnim neurološkim deficitima. U završnom radu je prikazan slučaj 73-godišnjeg bolesnika kojem je u hitnoj službi KBC-a Split dijagnosticiran cerebralni infarkt zbog tromboze cerebralnih arterija te je postavljena indikacija za aspiracijsku tombektomiju. Bolesnik je dobrog općeg stanja, uz povlačenje simptoma moždanog udara otpušten na kućnu njegu. |
| Abstract (english) | AIM: The aim of the final paper is to present the treatment and care for a patient with a diagnosis of acute ischemic stroke through tests of health care and nursing care. The paper will present patient care before and after the thrombectomy procedure, and patient education for the purpose of preventing repeated strokes.
DISCUSSION: Patient B.B., 73 years old, came to the emergency department of the Clinical Hospital Center (KBC) Split on March 19, 2023 due to the onset of weakness in the right limbs with speech disorders. In the emergency department, a computed tomography (CT) was performed, which did not show any form of intracranial bleeding, while a hypodense area was seen in the left parietal-occipital area, which corresponds to the initial demarcation of the ischemic area, and an indication was set for performing the aspiration thrombectomy procedure. Nurses anticipate the needs of patients, recognize possible complications of procedures and maintain patient safety. During the mechanical thrombectomy procedure, the nurse plays a key role in the assessment of prevention, early identification and monitoring of possible signs of neurological deterioration, application of procedural drugs, proper documentation of the procedure. The patient is conscious, hypertensive, and complains of pain on admission to the neurological intensive care unit. place of the procedure. The nurse connected the patient to a monitor with recommendations for monitoring vital functions. The nurse makes nursing diagnoses and provides nursing care through the health care process.
CONCLUSIONS: Cerebrovascular insult, commonly known as stroke, is generally classified as ischemic or hemorrhagic. In both categories, the result is a loss of blood flow, nutrients and oxygen to the brain area, resulting in neuronal damage and consequent neurological deficits. The final paper presents the case of a 73-year-old patient who was diagnosed with cerebral infarction due to thrombosis of the cerebral arteries in the emergency department of KBC Split, and an indication for aspiration tombectomy was set. The patient is in a good general condition, with the withdrawal of stroke symptoms and was discharged to home care. |
