Nursing Care for Stroke Patients : 2 Case Studies

Abstract

Stroke is a major global public health concern, ranking among the leading causes of death and disability in Thailand. Patients require systematic nursing care spanning the acute, inpatient, and rehabilitation phases. Initial nursing assessment is crucial for identifying patient problems. This study aimed to comparatively study two stroke cases presenting at the Outpatient Department (OPD) of Khon Kaen Hospital and to develop appropriate nursing guidelines, utilizing Gordon’s Functional Health Patterns as the assessment framework.

Methods: This was a qualitative case study design, involving data collection from two stroke patients between January and March 2025. Data were gathered from medical records, observation, and family interviews. Gordon's 11 Functional Health Patterns were used to assess problems and create a comparative table of nursing diagnoses across three phases: the initial screening phase in the OPD, the treatment phase in the Intensive Care Unit (ICU), and the rehabilitation phase. Data analysis involved descriptive comparison of symptoms, risk factors, diagnostic results, and ongoing care guidelines for both cases.

Results: Case 1, a patient with Ischemic Stroke, received treatment with recombinant Tissue Plasminogen Activator (rt-PA). Case 2, a patient with Hemorrhagic Stroke, underwent surgical decompression for increased intracranial pressure. Significant differences were observed between the two cases regarding risk factors, clinical manifestation, laboratory findings, and definitive treatment.

Conclusion: Systematic assessment and screening in the Outpatient Department facilitate the rapid classification of stroke type and appropriate referral for timely and effective management.