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Isbar Stroke

This patient is a 52-year-old male presenting with an acute stroke and large left MCA clot. He received tPA but also requires a thrombolectomy due to the size of the clot. His vitals are stable after treatment for elevated blood pressure. The neurologist has ordered a thrombolectomy, and the patient is being prepared for the procedure with consent obtained. The oncoming nurse is being updated to care for the patient during the thrombolectomy.

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56 views

Isbar Stroke

This patient is a 52-year-old male presenting with an acute stroke and large left MCA clot. He received tPA but also requires a thrombolectomy due to the size of the clot. His vitals are stable after treatment for elevated blood pressure. The neurologist has ordered a thrombolectomy, and the patient is being prepared for the procedure with consent obtained. The oncoming nurse is being updated to care for the patient during the thrombolectomy.

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© © All Rights Reserved
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This is a report given to the oncoming nurse taking the pt to IR for his embolectomy

ISBAR ACTIVITY STUDENT WORKSHEET


INTRODUCTION Hi, I’m Brittany, the med/surg nurse taking care of this patient.

Your name, position (RN), unit you are working


on
SITUATION This is Scott, a 52 year old male, who is here with symptoms of
an acute stroke.
Patient’s name, age, specific reason for the visit

BACKGROUND He came in today with right sided hemiparesis, right sided


weakness, right sided facial droop and slurred speech since 1020
Patient’s primary diagnosis, date of this AM. He has a pMHx of hypertension and a self-resolved
admission, current orders for patient suspected TIA 2 weeks ago. He’s not on any blood thinners, has
no active bleeding, or any history of brain hemorrhage. He is
receiving his TPA 9mg IV now, but it’s a large clot and he has
orders for a thrombolectomy now as well.
ASSESSMENT He had a CT done that showed a large left MCA clot with large
mismatch. ECG showed normal sinus rhythm, and a CBC,
Current pertinent assessment data using headto toe Chem8, and INR was sent to the lab, the creatinine was 1.3, but
approach, pertinent diagnostics, vital signs the rest of the labs were WDL.
His last set of vitals are as follows: BP – 170/89, HR – 89bpm,
RR – 20, temp – 98.6F, SpO2 – 99% on 2L O2 via NP.
He is A+Ox3, GCS 15, NIH Stroke Scale is 14. Pupils are equal
and reactive to light. He has right-sided hemiparesis, weakness
and facial droop, with slurred speech.
Chest is clear with good A/E bilaterally, no WOB noted.
His systolic blood pressure was initially in the 190’s, but we
treated with a total of 30mg labetalol IV. Skin is warm and well
perfused, cap refill brisk. S1 and S2 heard, no murmurs.
Abdomen is soft, not distended or tender, bowel sounds present
x4, no nausea/vomiting.
He has 2 PIVs in the ACs, both 18g, infusing well, with no
swelling, redness, signs of phlebitis or infiltration.
RECOMMENDATION The neurologist just ordered the thrombolectomy now, she has
already gotten the consent from the patient and they are already
Any orders or recommendations you mayhave for this preparing the angiocath lab for the procedure. The TPA is almost
patient done infusing, so it will just have to be flushed when it’s
completed. Other than that, you just need to prepare Mr. Scott for
his procedure.

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