Stroke and subdural hematoma (SDH) significantly impact several interrelated physiological processes, including intracranial regulation, thermoregulation, sleep, and sensory perception. Intracranial regulation involves maintaining stable intracranial pressure (ICP) through the balance of cerebrospinal fluid, blood flow, and brain tissue volume. In stroke and SDH patients, increased ICP from bleeding or blocked blood flow can lead to brain herniation if untreated (Laskowitz & Grant, 2016). Thermoregulation, controlled by the hypothalamus, can be disrupted in these patients, leading to abnormal body temperatures, which can exacerbate brain injury (Parsons et al., 2020). Elevated ICP and the discomfort associated with stroke and SDH often result in sleep disorders, including insomnia and hypersomnia, due to the direct impact on brain regions regulating sleep (Bassetti & Hermann, 2011). Sensory perception can be compromised as well, with patients experiencing deficits in vision, hearing, touch, and proprioception due to damaged sensory pathways in the brain (Cohen, 2017). These interconnected systems influence each other significantly; for instance, poor sleep can worsen ICP, and impaired sensory perception can affect thermoregulation and sleep quality. Understanding these interrelationships is crucial for effectively managing and improving the recovery and quality of life in stroke and SDH patients (Kraus & Maki, 2017).
This case study explores nursing practice concepts designed to improve critical thinking and clinical judgment. Please review each lesson, then open the SDH Case Study. In this lesson, you will find two quizzes and medical records associated with them. This case study builds on itself and the medical record in the second quiz has different information than the first quiz. After completing the quizzes compleat the survey and you will be able to print out a course completion certificate. After you attend the Zoom lecture on June 4th at 10:00 am you will earn 10 clinical replacement hours. There are 16 questions in this case study, over two quizzes, and a final evaluation form, in which you will get a course completion certificate.
If you have your limited license through OSBN, complete the didactic case study before the Zoom meeting on June 4th, and participate in the discussion after the case study, you will qualify to earn 10 clinical replacement hours.
Learning Objectives:
- Conduct comprehensive neurological assessments and recognize signs and symptoms of increased intracranial pressure and other neurological deficits.
- Develop strategies for assessing and communicating with non-verbal patients due to conditions like global aphasia.
- Implement nursing interventions focused on symptom relief and comfort care for patients with terminal or advanced conditions.
- Provide compassionate support and education to family members of critically ill patients.
- Monitor patients closely for changes in their condition and respond appropriately to ensure safety and comfort.
- The student will demonstrate an understanding of underlying health conditions that can affect the current presenting problem.
- Demonstrate the ability to identify and honor patient wishes as stated in advanced directives, including understanding the ethical and legal implications.
- Apply ethical principles to nursing practice, particularly in end-of-life care scenarios.
- The student will demonstrate interprofessional care coordination when addressing discharge planning.
