Whether you are a nurse or a travel nurse, you already know that every facility does things a little bit differently, but the nursing care plan remains the same. A nursing care plan (NCP) helps nurses to prioritize care, protect their license, and align with patient goals, no matter where they are working. In this blog, we explain the nursing care plan for stroke (CVA), the diagnosis, goals, and interventions, so let’s start!
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What is a Nursing Care Plan (NCP)? Nursing Care Plan for Stroke (CVA) example
What is a stroke?
A stroke happens when the blood flow to the brain is suddenly blocked or interrupted, or when the blood vessels in the brain burst, leading to brain cell damage. If the brain is not getting enough oxygen or nutrients, then the brain cells start to die in minutes that can lead to death.
Types of Stroke
There are three types of stroke (cerebrovascular accident – CVA)
- Ischemic stroke: It is the most common stroke that is caused by a blood clot blocking an artery in the brain.
- Hemorrhagic stroke: This stroke is caused by a ruptured blood vessel, which results in bleeding in or around the brain.
- Transient Ischemic Attack (TIA): This is the major warning sign for future stroke, and it is a temporary blockage of blood flow that resolves within 24 hrs.
Common signs and symptoms of stroke (FAST)
Nurses should use the” FAST” stroke warning system to recognize stroke before brain damage happens. This is an acronym that nurses and travel nurses use to recognize the early signs of stroke.
F: Face Drooping
This happens because the nerves controlling the facial muscles are affected by a stroke. Nurses will see one side of the face drooping, or the smile is uneven.
A: Arm Weakness
The weakness of one side of the body is a major sign of stroke. Ask the patient to lift their arm. If they are unable to do so or the arm feels numb or weak, then it is a classic sign of a stroke.
S: Speech Difficulty
A stroke can affect the communication center of the brain. The patient may struggle to find words to speak or sound confused.
T: Time to call 911
If any of the above signs are present in the patient, then immediately call 911 because during a stroke, brain cells start dying within minutes, which can lead to the patient’s death.
Some other symptoms of stroke include severe headaches, dizziness, vision problems, etc.
What is a Nursing Care Plan (NCP)?
A nursing care plan is a structured approach that nurses and travel nurses use to plan, deliver, and evaluate patient care. A nursing care plan helps nurses identify patient problems, set measurable goals, plan and deliver nursing interventions, and then evaluate patient outcomes. NCP consists of the following:
- Nursing assessment
- Nursing diagnosis
- Planning
- Implementation
- Evaluation
Nursing care plan example for stroke
Here is an example of a nursing care plan for stroke:
Assessment:
Collecting patient data to identify patient problems, consisting of objective and subjective data.
Subjective data: The information that is collected from the patient and is not measurable. It is the personal experience and feelings of the patient, for example:
- “I can’t move my right arm.”
- “I feel dizzy, and my speech feels heavy.”
Objective data: The information that can be observed, measured, and verified by a nurse, for example:
- BP of the patient is 170/98 mmHg.
- Facial droop on the right side.
- Slurred speech.
Nursing diagnosis:
Identifying health problems based on assessment. Usually follows NANDA-I guidelines. It consists of actual and potential problems. Nursing diagnosis for a stroke patient includes the following:
Impaired physical mobility:
A stroke causes weakness or paralysis on one side, limiting movement. The signs include difficulty in walking, abnormal reflexes, etc.
Risk for aspiration:
Swallowing difficulties or dysphagia are very common in stroke patients, increasing the risk of choking. The signs include coughing during meals, delayed swallowing reflexes, etc.
Impaired verbal communication:
Stroke affects the communication of patients, and they are unable to speak. The signs include slurred speech, confusion, and inability to find words.
Planning:
Planning in a nursing care plan means setting measurable, realistic, and time-bound goals. Nurses use SMART (Specific, Measurable, Achievable, Realistic, Time-bound) goals for their planning. It consists of both short-term goals and long-term goals. Here is an example of goals for a stroke patient at risk of aspiration.
Short-term goals:
Patients will be able to eat without showing any signs of airway obstruction. This goal focuses on immediate safety as patients with stroke have a high risk of choking.
Long-term goals:
Patients will be able to eat food and swallow liquid using recommended techniques within 1 week. The goal focuses on independence, which means the patient learns to safely manage meals long-term.
Implementation:
Steps or actions taken by nurses to achieve goals is called nursing interventions. Nursing interventions can be dependent, independent, or collaborative. The nursing interventions for the patient with a stroke are as follows:
- Dependent intervention: Nurses need the provider’s order to carry out the intervention. For example, giving antibiotics if the patient develops aspiration pneumonia.
- Independent intervention: Nurses don’t need a doctor’s order to carry out the intervention, for example, positioning the patient upright during meals, and encouraging the patient to take small bites and sips.
- Collaborative intervention: Nurses collaborating with a speech language pathologist (SLP) to provide specialized swallowing therapy to patients.
Evaluation:
Evaluation in the nursing care plan means determining whether the goals were met and interventions were effective. Examples of evaluation in the nursing care plan of a patient with a stroke are as follows:
- The patient can move an arm or leg and demonstrate improved mobility.
- Patient is able to understand and follow simple commands during therapy.
- No coughing, choking, or signs of aspiration during meals.
Nursing care plan resources:
Mastering Nursing Care Plans: A Comprehensive Guide for Nurses
Mastering Nursing Documentation: How to Write Effective Nursing Notes
Nursing Concept Maps Made Easy: Step-by-Step Guide for Beginners
Nursing Care Plan (NCP) for Acute Pain: Diagnosis, Goals, and Interventions
Anemia Nursing Care Plan (NCP): Assessment, Goals, and Interventions
Conclusion
A nursing care plan (NCP) is a tool for nurses and travel nurses to provide effective and patient-centered care. For stroke patient, NCP helps to guide assessment, set realistic goals, plan interventions, and evaluate outcomes to ensure patient recovery. Whether you are a permanent nurse or a travel nurse working in different health care facilities around the US, following the nursing care plan keeps patient care consistent and professional.
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