Application of Orem’s Theory in Nursing Care for Patients with Ischemic Stroke Receiving Thrombolytic Drugs and Mechanical Thrombectomy: A Case Study

Abstract

Abstract: Ischemic stroke is a leading cause of death and disability in adults, with survivors often experiencing severe functional impairment that significantly affects their physical, psychological, social, and economic quality of life. Therefore, promoting self-care and preventing complications are of paramount importance. This case study applied Orem’s SelfCare Theory as a conceptual framework for the care of a 72-year-old male patient diagnosed with ischemic stroke who received intravenous thrombolytic therapy and subsequent mechanical thrombectomy. The nursing outcomes revealed that the patient experienced self-care deficits during the acute, post-acute, and rehabilitation phases. The nurse’s crucial role focused on promoting the patient’s self-care agency through physical rehabilitation, modifying health behaviors to reduce risk factors, and managing the condition at home. Key complications prevented included intracranial hemorrhage, complications at the puncture site (e.g., hematoma), and aspiration pneumonia. Furthermore, the nurse collaborated with the multidisciplinary team on planning continuous rehabilitation and coordinating transitional care following discharge (Intermediate Care: IMC). Consequently, the patient safely passed the critical phase, achieved appropriate functional recovery, and was discharged home within 8 days. In conclusion, Orem’s Self-Care Deficiency Theory systematically guides nurses in assessing the patient’s needs and self-care abilities, formulating nursing diagnoses, and planning appropriate interventions across all stages of illness, from the critical phase to discharge planning and rehabilitation. Integrating care from the multidisciplinary team is essential to empower patients to manage their self-care, modify behaviors, prevent complications, and achieve a good quality of life.