NCLEX Stroke Case Study: Ischemic CVA, tPA Protocol, and 5 Priority Nursing Interventions

This comprehensive Stroke (CVA) Nursing Case Study follows the clinical presentation and management of a 68-year-old male (Mr. John K) suffering from an Acute Ischemic Stroke. Perfect for Med-Surg and NCLEX preparation, this resource provides a real-world look at neurological assessment, diagnostic reasoning, and evidence-based nursing care. What is included in this case study: Patient Profile & Assessment: Detailed history of a patient with poorly controlled hypertension, Type 2 Diabetes, and Atrial Fibrillation . Symptom Analysis: A breakdown of classic stroke signs, including right-sided hemiparesis (2/5 strength), facial droop, dysarthria (slurred speech), and dysphagia . Critical Diagnostics: Explanation of why a CT scan is the priority first test to differentiate between ischemic and hemorrhagic stroke . Medical Management: Detailed analysis of the 4.5-hour tPA (Alteplase) window and the goals of thrombolytic therapy . Nursing Care & Interventions: Five priority nursing actions including airway maintenance, 30° head-of-bed elevation, and neurological monitoring using the Glasgow Coma Scale . Complete Nursing Care Plan: Features a full care plan for Risk for Aspiration, including specific interventions like NPO status, upright positioning, and monitoring for coughing . Patient Education: High-yield discharge teaching points on smoking cessation, blood glucose monitoring, and BP control . This document is designed to help nursing students bridge the gap between textbook theory and clinical practice, ensuring a deep understanding of contralateral deficits and acute stroke recovery .