New approaches to the nursing care of the stroke patient.

Prevention and maintenance constitute a large part of the nurse's role in caring for the stroke patient during the acute stage of his illness. The nurse must have knowledge of both the subjective and objective effects of a stroke to formulate an effective Nursing Care Plan. Consistency is vital in providing an environment in which a stroke patient can relearn fundamental activities. Confusion, and thus the diminished ability to learn, is often relieved by familiarity and predictability of surroundings, persons, and routines. Nursing's participation in positioning, range of motion exercises, bowel and bladder retraining and providing appropriate sensory input is essential. The nurse must assume the role of coordinator and evaluator of the patient's rehabilitation, using 24 hour-a-day observation coupled with educational background and experience, to determine obs-acles and assess the patient's ability to resume living in his previous environment.