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Related Concept Videos

Atherosclerosis IV: Nursing Management01:23

Atherosclerosis IV: Nursing Management

Nursing management for a patient with arteriosclerosis involves a comprehensive approach focusing on lifestyle modification, disease monitoring, education, and symptomatic care. Here is an overview of effective nursing strategies:Assessment and Monitoring: Initial and ongoing assessments are crucial. Nurses must document the patient's medical history, including any hypertension, diabetes, hyperlipidemia, and other cardiovascular diseases. Assessments also cover family history and lifestyle...
Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
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Venous Thrombosis IV: Nursing Management

Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
Peripheral Artery Disease IV: Nursing Management01:26

Peripheral Artery Disease IV: Nursing Management

The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses, temperature changes,...
Angina V: Nursing Management01:20

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Cognitive Function and Upper Limb Rehabilitation Training Post-Stroke Using a Digital Occupational Training System
07:35

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Published on: December 29, 2023

Utility of a post-hospitalization stroke prevention program managed by nurses.

Kelly D Flemming1, Thomas G Allison, Jody L Covalt

  • 1Department of Neurology, Mayo Stroke Center; Mayo Clinic, Rochester, MN. flemming.kelly@mayo.edu.

Hospital Practice (1995)
|August 17, 2013
PubMed
Summary

A nurse case-management program improved vascular risk factors in patients with cerebral ischemia. This approach showed potential for better long-term stroke risk control, warranting further investigation in larger trials.

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Area of Science:

  • Neurology
  • Cardiovascular Medicine
  • Public Health

Background:

  • Clinical practice often shows gaps in implementing evidence-based guidelines for cerebral ischemia prevention and treatment.
  • Vascular risk factors significantly contribute to the occurrence and severity of cerebral ischemia.

Purpose of the Study:

  • To evaluate the effectiveness of a physician-directed, nurse-case-management program in reducing individual vascular risk factors in patients hospitalized with atherosclerotic cerebral ischemia.
  • To assess the program's impact on major stroke risk factors such as hypertension, tobacco use, dyslipidemia, and diabetes.

Main Methods:

  • A randomized controlled trial involving patients with atherosclerotic cerebral ischemia and at least one major uncontrolled risk factor.
  • Patients were assigned to either a nurse-prevention program (individualized education, motivational interviewing, dietitian/exercise physiologist consultation) or usual care.
  • The primary endpoint was the improvement of at least one major stroke risk factor to goal at one year post-hospitalization.

Main Results:

  • The nurse-care-management group showed a 42% higher likelihood of meeting the primary endpoint compared to usual care (61% vs. 33%).
  • Significant reductions in low-density lipoprotein cholesterol, cardiovascular risk score, and systolic blood pressure were observed in the prevention group.
  • Patients in the prevention group demonstrated greater adherence to prescribed diets (50% vs. 7%) and exercise programs (83% vs. 33%).

Conclusions:

  • A physician-directed, nurse case-management system is a feasible approach for post-hospitalization care of cerebral ischemia patients.
  • This program shows promise in improving long-term control of major stroke risk factors.
  • A larger trial is recommended to confirm these preliminary findings.