How to care for a stroke patient

       Create a beautiful and comfortable environment for the patient, maintain the room temperature at 18~22 degrees Celsius and humidity at 50~60 percent. Patients with hemiplegia should pay special attention to safety because of sensory impairment of the affected limbs, emotional instability and restlessness.  Stroke patients with reduced digestive function should be given a low-fat, low-sugar, high-protein, high-vitamin, easy-to-digest diet with small and frequent meals.  As the patient is bedridden for a long time, the gastrointestinal motility is weakened and constipation can easily occur, and the effort of defecation can increase the cranial pressure and further aggravate the condition. Patients can eat bananas, honey, etc., to ensure adequate fluid intake. If necessary, use laxatives and cathartics as prescribed by the doctor.  Pay attention to personal hygiene. Wash the perineum and change underwear regularly. For female patients, perform perineal irrigation twice a day. For patients with indwelling catheters, disinfect the urethra twice a day to keep the outer end of the catheter clean.  To prevent bed sores, we should do “five diligent” nursing care: turn, scrub, massage, organize, and change. Turning should be done gently, avoiding dragging, pulling and pushing, and those who should not turn can raise the foot of the bed by 30-40 degrees. Every 1-2h, use about 250px thick soft pillow to pad the patient’s lumbosacral area to increase local permeability and reduce pressure on the pressurized part. The hand can be extended to the back to gently press and rub to improve local blood circulation.  Rehabilitation care for the affected limb (1) Maintain the functional position of the affected limb: Keep the joint in the functional position after the onset of hemiplegia. Choose a suitable mattress to prevent joint contracture and deformity. The hands should be in a semi-clenched fist, the shoulder joint in a “salute” position, the elbow joint at 90 degrees, the wrist joint dorsiflexed at 30-40 degrees, a pillow under the knee, the hip joint straightened to prevent external rotation of the lower limb, and the ankle joint at 90 degrees.  (2) Passive movement of the affected limb: change the position regularly, turn over once every 2 hours, and position the patient in a lateral or semi-lateral position with the affected side underneath or on top. Help the patient to do the passive flexion and extension, inversion, abduction, internal and external rotation of the joints of the affected upper and lower limbs, and make the patient cooperate with the intentional movement during the passive movement. Gradually move from the proximal to the distal end of the limb, with each joint moving 3-4 times a day, about 10 times each time.  (3) Bed training for physical activities: let the patient learn to turn over and use the toilet by himself. First, the patient should cross his fingers and hold his hands, and perform passive shoulder joint activities. Do hip extension movements, such as double bridge exercises, while practicing turning. Exercise to raise the hips and learn to use the commode by themselves or with the assistance of a nurse.  Psychological rehabilitation care Most patients after stroke are usually accompanied by depression and anxiety, which are manifested by little speech, indifference, lack of initiative, skepticism about treatment and training, depression, and even light-heartedness in some cases, which is negatively correlated with the level of physical ability and language impairment. The recovery of neurological function after stroke is usually fastest within 3 months after the disease. Active psychological counseling during this period can promote the rate of recovery.