CAPITOL UNIVERSITY College of Nursing Cagayan de Oro City Name: Rex Dave C. Mortiz Section/ CN: 149 Date: 04/13/22 Discharge Plan #: 1 DISCHARGE PLAN FOR PATIENTS WITH ISCHEMIC STROKE - GOALS MEDICATION EXERCISE TREATMENT/ THERAPY The patient and family will have adequate knowledge about the etiology of the disease and able to understand the intervention needed to be done to prevent the reoccurrence of ischemic stroke and lessened the complications of stroke. And also, include the family in the plan of care that improve the patient’s well being and able to achieve total independence. And the patient will able to verbalize the satisfaction of the course of treatment. And this includes improve mobility, promote comfort and communication, prevention of aspiration, promote proper defecation and urination, maintain skin integrity, and absence of complications. Encourage the patient to follow these guidelines upon taking the medication: - Take the medication as directed by the physician, adhere to the schedule given by the physician/ - Ask what side effects could occur, and report it to your physician immediately. - Do not share your prescription medication. - Medication can be dangerous when mixed. Instruct the patient to adhere religiously to the drug regimen to reduce the reoccurrence of stroke and able to prevent any complications: • Anticoagulant medication – to thin the blood. • Antiplatelet medication – to dissolve or prevent clotting that is potential to cause an emboli • Antihypertensive – to reduce the risk for stroke which lowers the blood pressure of the patient. - Encourage the patient to stay active as possible, cause inactivity can slow or prevent the recovery, activities that will increase or muscular strength, such exercises are walking, gardening, cycling and more. - Instruct the patient to passively exercise the affected extremities to prevent venous stasis that will prevent venous statis that could lead to venous thromboembolism. This is will help to maintain full ROM and joint mobility, regain and maintain muscle strength, prevent contractures in the affected extremity, further deterioration and promote circulation. - Encourage the patient to use the Mirror Therapy were using a tabletop mirror to cover the affected extremity with the function arm, then the patient will perform certain exercise while looking at the reflection. Study shows, to activate the signals from the hand to brain, which helps to activate neuroplasticity and slowly improve mobility in the affected hand. - Instruct the patient to adhere with the thrombolytic therapy, if prescribed b the physician, this therapy uses tissue plasminogen activator or tPa, the treatment works to dissolve the clots that are blocking the blood flow in the arteries in the brain. Take note that it should be given a window period of 3 hours, and can be extend to 4.5 hours. MEDICAL-SURGICAL NURSING NCM 116 DISCHARGE PLAN FORMAT Professor: Emman M. Parangue, R.N. - HEALTH TEACHINGS OUT-PATIENT DEPT (CONSULTATION) DIET Instruct the patient about the warning signs of stroke because reoccurrence might happen and able to receive immediate treatment and prevent any complications, by using the acronym BE FAST (B = Sudden loss of Balance; E = Loss of vision in one or both Eyes; F = Face droops on one side; A = Arm drops when both arms are raised; S = Speech is slurred or sound different; T = Time to get help immediately)/ - Encourage the patient to make their home safe, such prevent on anything that can might cause to trip over, put nonslip materials on surface that are slippery. - Maintain a healthy weight, overweight and obesity increases the risk for stroke, and able to manage stress efficiently by advising the client ways to relax such as deep breathing exercise, guided imagery, or listening to music. - Monitor blood pressure daily or as directed, because high blood pressure increases the risk for stroke. - Maintain a healthy lifestyle, and this includes avoid smoking because nicotine and other chemicals present in the cigarette can cause blood vessel damage which increases the risk for stroke. - And the patient’s communication is impaired proved various ways to communicate with primary care provider, the nurse and the family such are using communication board or allow the patient to speak slowly and keep the language of instruction consistent. - Drink alcohol only in moderation (1-2 drinks per day). - The first three months is the critical time after stroke, it is important for the patient to have a follow up checkup, after 30 days the patient would need to return and need to assess the improvement of the treatment and medications given to the patient. And the patient will have these follow up appointments: 6 months and 1 year after the incident of stroke, then the patient should have a follow up check up once a year. Having a healthy diet is vital ono promoting health and prevention of reoccurrence of ischemic stroke, this are the following recommendations need to follow by the patient: 1.) Avoid processed foods, salt and sugar - Processed foods typically contain a lot of sugar and salt that contributes to plaque build up that can cause ischemic stroke, and also salt is directly related to high blood pressure. Replacing processed foods and seasoning meals to whole foods. 2.) Eat more Legumes - Legumes are best sources of proteins and vitamins are tit is low fat. 3.) Eat fish and Poultry instead of red meat - Study shows that read meat increases the risk for ischemic strike because of the saturated fats present in red meat, while fish and poultry reduces the risk for heart diseases and also it contain healthy fats which is called unsaturated fats. 4.) Avoid saturated fat MEDICAL-SURGICAL NURSING NCM 116 DISCHARGE PLAN FORMAT Professor: Emman M. Parangue, R.N.
