Patient care management goal: to support the patient’s vital functions, restore cerebral blood flow, minimize neurologic deficits, and prevent progression
- Maintain a patent airway to promote adequate oxygenation
- Administer oxygen therapy with possible intubation and mechanical ventilation to ensure adequate tissue perfusion
- Maintain bed rest to minimize metabolic requirements
- Provide I.V. fluids to support blood pressure and maintain volume
- Administer dexamethasone to reduce cerebral edema
- Administer anticoagulants and antiplatelet drugs for thrombotic conditions after hemorrhage has been ruled out
- Administer sedatives, such as Phenobarbital, to decrease metabolic requirements
- Assess the patient’s neurologic status; observe for CVA progression and level of consciousness (LOC) change as evidenced by decreasing numerical score on the GLASGOW COMA SCALE.
- Correct cardiovascular abnormalities, such as atrial fibrillation, that may be contributing factors
- Consider surgical procedures to correct circulatory impairment, prevent repeated hemorrhage, or relieve cerebral pressure
- Begin bedside range-of-motion exercise to preserve mobility and prevent deformities
- Teach the patient to identify risk factors and necessary life-style modifications, such as diet, stress reduction, and smoking cessation
- Direct the family to community groups that provide support or rehabilitation
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