You are preparing to work as a nurse in the neurology unit. The preceptor informs you to be prepared to discuss the following topics as they are commonly seen on the unit. In order to prepare, choose one of the following topics of interest as your initial discussion posting. Use this course’s resources and one evidenced-based article to explore the topic of your choice.
- How do you assess a client when the nurse suspects onset of CVA?
- Provide discharge information for a client with mild TBI.
- Discuss surgical management of brain tumors.
- Describe postoperative complications of a craniotomy.
When responding to the initial posting, provide an evidence-based article to support your response. Respond to two other topics different than your initial topic with a reference.
As a nurse preparing to work in the neurology unit, one of the common topics that may arise is how to assess a client when the nurse suspects onset of CVA (cerebrovascular accident), commonly known as a stroke. This is an important topic for nurses to be knowledgeable about as early recognition and prompt treatment of stroke can significantly improve patient outcomes.
The assessment of a client suspected of having a stroke begins with a quick assessment of the ABCs (airway, breathing, circulation) to ensure the patient is stable. Then, the nurse should focus on obtaining a thorough neurological assessment, which includes assessing the patient’s level of consciousness, speech, vision, strength, sensation, and coordination. The National Institute of Neurological Disorders and Stroke (NINDS) has developed a useful tool called the NIH Stroke Scale that can help standardize the neurological assessment of stroke patients.
In addition to the neurological assessment, the nurse should also obtain a thorough medical history, including any risk factors for stroke, such as hypertension, diabetes, and smoking. Time is a critical factor in the treatment of stroke, and therefore it is important for the nurse to note the time of onset of symptoms and alert the healthcare team immediately.
An evidenced-based article that supports the assessment of a client with suspected stroke is a review article by Powers et al. (2019), which outlines the 2019 update to the American Heart Association/American Stroke Association guidelines for the early management of patients with acute ischemic stroke. The article emphasizes the importance of a rapid and thorough neurological assessment, including the use of validated stroke scales, and the urgent initiation of intravenous alteplase, a thrombolytic medication, in eligible patients within 3-4.5 hours of symptom onset.
In conclusion, as a nurse in the neurology unit, it is important to be prepared to assess a client with suspected stroke promptly and accurately. A thorough neurological assessment, medical history, and timely communication with the healthcare team can help ensure that the patient receives the appropriate treatment within the critical time window.
Reference: Powers, W. J., Rabinstein, A. A., Ackerson, T., Adeoye, O. M., Bambakidis, N. C., Becker, K., … & Khatri, P. (2019). 2019 Guidelines for the Early Management of Patients with Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke, 50(12), e344-e418. doi: 10.1161/STR.0000000000000211