Case study of a patient with hemorrhagic stroke: addressing the need for oxygenation/circulation in a neurocritical context

Ana K. Rodríguez-Guendulain, Consulta Externa, Instituto de Salud del Estado de México, Centro de Salud Ciudad Lago, Nezahualcóyotl, Estado de México, México

The integral approach of a patient with cerebrovascular accident (CVA) of hemorrhagic origin, treated in the neurology service, highlighting the role of the nursing professional in prioritizing altered needs through Virginia Henderson’s 14 needs model. Hemorrhagic CVA, caused by the rupture of a cerebral blood vessel, is the second leading cause of death worldwide and one of the main causes of loss of disability-adjusted life years, according to the World Health Organization. The objective of this report is to visualize the practical application of clinical nursing judgment in a critical condition that represents a frequent and complex challenge in specialized neurological care. The nursing process was used as methodology through data collection by means of an instrument based on 14 basic needs. Sources of information: direct, nursing sheet, clinical file (nursing sheets, laboratory studies, cabinet), interview with primary carer and database analysis. This is a male with history of arterial hypertension not controlled, begins with decreased alertness, headache, nausea, vomiting, decreased visual acuity, generalized weakness. In the emergency room it presents stupor data, enters the operating room for ventriculostomy placement. Later in neurology begins with intercostal draw and apnetic breaths so that advanced management of the airway is given. Due to this problem, the application of specialized nursing care was carried out, based on the model of the 14 needs having as methodology the process of nursing care, which allows an effective intervention in patients with hemorrhagic CVA. Actions focused on oxygenation/circulation and neuroprotection contribute to improve clinical status, reduce complications and promote functional recovery. Advanced training of the nursing professional is key to provide comprehensive care during the critical phase.

Keywords: Cerebrovascular disease. Intracranial hemorrhage. Arterial hypertension. Intraparenchymal hemorrhage. Nursing diagnoses.