Assignment: Discuss the following management for Stroke:

Surgical Treatment
IV Fluids
Rest 
Management of other Medical Problems
Speech, Physical and Occupational Therapy
Patient Education

Surgical Treatment
Carotid endarterectomy. This is the removal of atherosclerotic plaque or thrombus from the
carotid artery to prevent stroke in patients with occlusive disease of the extracranial cerebral
arteries.
Hemicraniectomy. May be performed for increased ICP from brain edema in severe cases of
stroke.
Iv Fluids
Given into a vein (Intravenous or iv) or under the skin (subcutaneous) are commonly used in
people with stroke, but there are no clear guidelines on the best fluid management in such
cases. There are number of possible different types of fluid that can be used: isotonic fluids, or
crystalloids are solutions that contain similar amounts of dissolved salts as in normal cells and
blood, whilst hypertonic fluids, colloids usually contain more (or larger) dissolved particles than
in normal cells and blood.

Rest
Quality sleep has many benefits for stroke survivors. Getting a good nights sleep supports
neuroplasticity, the brain’s ability to restructure and create new neural connections in healthy
parts of the brain, allowing stroke survivors to relearn movements and functions.

Management of other Medical Problems

Patients who experience stroke should have medical management for secondary prevention

Recombinant tissue plasminogen activator would be prescribed unless contraindicated and

there should be monitoring for bleeding.

Increased ICP Management of increased ICP includes osmotic diuretics, maintenance of PaCO2
at 30-35 mmHg, and positioning to avoid hypoxia through elevation of the head of the bed.

Endotracheal Tube There is possibility of intubation to establish patent airway if necessary.

Hemodynamic monitoring Continuous hemodynamic monitoring should be implemented to

avoid an increase in blood pressure

Neurologic assessment to determine if the stroke is evolving and if other acute

complications are developing.

Patient Education

Patient and family education is fundamental component of rehabilitation

Consult an occupational therapist. An occupational therapist may be helpful assessing the home
environment and recommending modifications to help the patient becoming independent.
Physical therapy. A program of physical therapy may be beneficial, whether it takes place in the
home or in an outpatient program.
Antidepressant therapy. Depression is a common and serious problem in the patient who had
stroke.
Support groups. Community based stroke support groups may allow the patient and the family
to learn from others with similar problems and to share their experiences.
Assess caregivers. Nurses should assess caregivers for signs of depression, as depression is also
common among caregivers of stroke survivors.