Nursing care in a patient with ischemic stroke undergoing endovascular thrombectomy: A case report

Ischemic stroke is a major neurological emergency. Endovascular thrombectomy has emerged as an effective treatment for patients with large-vessel occlusion. Nursing care plays a decisive role in ensuring patient safety and optimizing outcomes. This case is about a 77-year-old male with a history of vascular risk factors presented with aphasia and right hemiparesis. Stroke protocol was activated. Imaging revealed an M2 segment occlusion of the left MCA. Endovascular thrombectomy was performed under general anesthesia. The nursing assessment was guided by Patricia Benner's Theory of Clinical Wisdom and operationalized through the ABCDE (Airway, Breathing, Circulation, Disability, Exposure) method and validated scales such as NIHSS (NIH Stroke Scale), GCS (Glasgow Coma Scale), ASPECTS (Alberta Stroke Program Early CT Score), and MRC (Medical Research Council) strength grading. Alterations were identified in airway management, mobility, communication, and hemodynamic stability.

Using the NANDA-I (North American Nursing Diagnosis Association International) taxonomy, nursing diagnoses were formulated and linked to Nursing Outcomes Classification (NOC) indicators and Nursing Interventions Classification (NIC) activities. Diagnoses included ineffective cerebral perfusion, risk of increased intracranial pressure, arrhythmia, risk of aspiration, acute pain, and anxiety, among others.

Nursing interventions were structured across three phases: pre-procedure (e.g., neurological stabilization, technical preparation), intra-procedure (e.g., hemodynamic monitoring, airway support), and post-procedure (e.g., neurovascular assessment, structured communication using ISBAR).

Person-centered, evidence-based nursing care supported procedural safety and early recovery. The systematic application of clinical tools and interprofessional collaboration were essential to preventing complications. The patient showed a favorable outcome with no neurological deficits at 48 h. Structured and theory-based nursing care across procedural phases is essential for ensuring safety, minimizing complications, and supporting recovery in patients undergoing thrombectomy for acute ischemic stroke.