Outcome Evaluation

• Stroke outcomes are measured based on the neurologic status and functioning of the patient after the acute event. The NIHSS is a measure of daily functioning and is used to assess patient status following a stroke.

• Early rehabilitation can reduce functional impairment after a stroke. Recent stroke rehabilitation guidelines have been endorsed by the American Heart Association and the American Stroke Association. These guidelines recommend that patients receive care in a multidisciplinary setting or stroke unit, receive early assessment using the NIHSS, and recommend that rehabilitation is started as soon as possible after the stroke. Other recommendations include screening for dysphagia and aggressive secondary stroke prevention treatments.51

Table 11-6 Monitoring the Stroke Patient

Pwsmdtrli]

Monitoring íitqutncy

tummenti

Ixchcmic Stroke

AlLtplüíí

BP, itmrotogk (uní Liua Dieting

tvery IS minutLi S 1 ívsji, uvwy O.J lyxif V e hftjr^íverí 1 hour v. 1? fBtB-i; then every ihlft

AV.

Sk^lirtfl

Djíy

QcptdDgfp)

Sk?edinti

Dtrty

A Wrfi dipyiidan*ile

Heartvln*. hlw^ling

tsáf

WicfiUlrt

Bkrding. INR. HtVIkl

INR tioily M J tfjyi: vjockly umil -^c.itjli then iivnmhly

Hemorrhagic Suoke

HP, iviiroltgii furxTioa íP

iwry 1 hckjri in K u

MlTi'iiKf,™** tffitnieflti DO IITAVI HF to leas than 180 mm Hg syslolk:

Nimortipine fiw^H

BP, nflutctogk: Tunccioa fluid jtAiS

Every ? hours in ICU

AÍA, aspirin if, blood pet-surei EHextendad-releas^; l ib; hemogtabirvHcl, hematacrl; ICH *Hracran'i1 pressure ICU, kdEnslve care unit IMK-InltfrLi: j)inl iJ- .■■!■. ilm'fl RitiCC £AH fubMClWid '"rnurrhiiir;"

AÍA, aspirin if, blood pet-surei EHextendad-releas^; l ib; hemogtabirvHcl, hematacrl; ICH *Hracran'i1 pressure ICU, kdEnslve care unit IMK-InltfrLi: j)inl iJ- .■■!■. ilm'fl RitiCC £AH fubMClWid '"rnurrhiiir;"

• Table 11-6 provides monitoring guidelines for the acute stroke patient.

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