Patient and Family Consent – Stroke Nursing Care in ER

by Rhonda Lawes, PhD, RN

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    00:00 When the health care provider looks at the results, what do you think they saw? Well, we ruled out any signs of bleeding.

    00:09 So the health care provider, the physician, he or she, looked at the lab results that are back, the report of the head CT, and they decided, obviously, to do another assessment of Mr. Johnson, because they want to start thinking about alteplase therapy. Now, alteplase is a thrombolytic drug. The reason we had to do that CT first is we wanted to make sure that he wasn't bleeding into his head.

    00:34 If Mr. Johnson has significant bleeding in his head, there'd be no way we would give a thrombolytic. But since we've ruled that out because you got him to CAT scan right away, and now we have the results back, that physician is ready to start thinking about the next step.

    00:49 So now it's time to talk to Mr. Johnson and his wife and their adult children at the bedside because you're going to discuss the current findings and the possible treatment options. Now, this is a key role for the nurse.

    01:03 The health care provider will meet with the patient and the family members that the patient feels is appropriate. So be sure to ask Mr. Johnson and his wife who they would like to be there. And the health care provider will lay out the options and help the patient and family understand all the positives and the negatives of the different treatment options.

    01:23 Your role, as a nurse, is to listen very carefully to what the healthcare provider is communicating, even good to take some short, brief notes because you have to think about what this family is going through. I mean, they were just having breakfast this morning. It was just a normal day, and now they're here in your ER. So it's very difficult for them to process information. These are likely very intelligent people, but the stress and trauma of everything that they're going through, makes it difficult for them to really process information.

    01:55 So by you taking short, careful notes, when the patient's family or the patient asks you questions, you make sure that you give them the same answers that the physician did, so you're all on the same page. Now, the physician laid out the options for thrombolytics.

    02:13 Mrs. Johnson and her children agree with the alteplase therapy, as does Mr. Johnson. So I know that's a little bit of a touchy subject because we know that he has suffered a stroke. So you'll have to kind of navigate that with the healthcare provider to see who's most appropriate to make that full decision.

    02:30 Okay. Back in CAT scan. Got the results. We've decided the next option is to consider alteplase or thrombolytic therapy.

    02:38 We've talked to the patient and their family, and everyone agrees they understand the risks of this therapy and they want to proceed.

    About the Lecture

    The lecture Patient and Family Consent – Stroke Nursing Care in ER by Rhonda Lawes, PhD, RN is from the course Neurology Case Study: Nursing Care of Stroke Patient.

    Included Quiz Questions

    1. The computed tomography (CT) scan ruled out an intracerebral hemorrhage.
    2. The computed tomography (CT) scan determined this was the only option to treat his signs and symptoms.
    3. Mr. Johnson's signs and symptoms indicated this was the best option for repair of the hemorrhage.
    4. The computed tomography (CT) scan ruled out an ischemic stroke.
    1. The client or client's representative
    2. The physician
    3. The RN
    4. The client, client's family, and physician

    Author of lecture Patient and Family Consent – Stroke Nursing Care in ER

     Rhonda Lawes, PhD, RN

    Rhonda Lawes, PhD, RN

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