Preventing subacute complications
Ongoing nursing care of the stroke patient includes
prevention of subacute complications. The nursing staff
in the ICU and the Progressive Care Unit continue to
monitor for, but also work to prevent complications
during and after the acute care phase of stroke.
Subacute complications include: malnutrition, aspiration,
pneumonia, urinary tract infection, bowel or
bladder dysfunction, deep vein thrombosis, pulmonary
embolism, contractures, joint abnormalities, falls, and
skin breakdown (Summers et al. 2009) In our facility,
care planning that proactively addresses potential subacute
complications has been developed. Nursing staff
work with the patient care team to monitor for signs of
dysphagia, and to maintain adequate nutritional intake
for the stroke patient. Skin-care rounds are used to
prevent and monitor for any skin breakdown. Physical
therapy works with the team to develop a rehab programme
for the patient as appropriate. Prevention of
infection, deep vein thrombosis, pulmonary embolism,
falls and bowel and bladder problems are ongoing.