الفهرس 
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Abstract
Acute stroke occurs because of changes in the blood vessels of the brain. The changes can be intrinsic to the vessel (atherosclerosis, inflammation, dilation of the vessel, weakening of the vessel, obstruction of the vessel) or extrinsic, such as when an embolism travels from the heart. The treatment consists of maintaining life, reducing intracranial pressure (ICP), limiting the extension of the stroke, and preventing complications. Critical care Nurses play a pivotal role in caring of patient at the emergency department, that helps to reduce patient further complications. Therefore the Aim of this study was to evaluate the effect of implementation of Nursing Guidelines on improvement of acute stroke patient outcomes. Quasi-experimental research design was used to conduct this study. The sample of this study consisted of 60 patients, who were admitted to the Emergency care unit and Neurology Intensive care unit at Assuit University Hospital. Tool used in this study consisted of three main tools:Tool I: - assessment of patient profile. This tool was developed by the researcher based on reviewing of the relevant literature; it includes two main parts as flowing. - Part one: patient characteristic:- It includes patient’s demographic data such as (patient’s sex, age), date of admission, and diagnosis, history of current disease, past medical diseases, and history of risk factor, also emergency data that help in assessment of patient’s condition on admission as (Onset of stroke and recurrence, to assess the patient’s profile. Part II: - this part consisted of three main categories as follows:-A- Assessment homodynamic state:-This part used to assess homodynamic changes and vital signs it includes (temperature, pulse, respirator rate, heart rate, systolic arterial blood pressure and Diastolic arterial blood pressure) which were assessed manually.B- Respiratory assessment:-That includes respiratory rate, assessment of bronchial secretions, skin, lips, nails bad color and abnormal breath sounds.C: - Assessment of fluid balance.Tool two: - (Assessment of patient Neurological status):-A-Which cover Neurological assessment in both groups using National Institution of Health Stroke Scale (NIHSS).B-In addition to assessment of level of conscious using Glasgow Coma Scale (GCS).<Assessment of swallowing function using bedside swallowing scale. D-Assessment of patient as regard medications administer.E-Laboratory tests findings assessment.Tool three: - (Assessment of acute stroke complications):-A-This includes assessment of both group reared acute stroke complications.B-also DVT symptoms appearance as (calf pain not disappear with rest , calf tenderness, warm calf, distention of superficial vein, swelling of extremities, redness or discoloration of affected area and tachycardia).The main results:The result of the current study revealed that majority of the study sample was over 55 years with a mean value (64.20±14.83 & 55.56±17.69 respectively) for the study and control group with no significant difference, While revealed significant difference between both groups regard type of acute stroke (p<0.03). Also show no significant difference between both group regard risk factors. On the other hand, the result showed significant decrease in vital signs from the 1st day to 7th day. With a mean temperature (38.41 ± 0.29 & 38.46 ± 0.29) with no significant in 1st day and high significant in 3rd day. Also revealed increase in SBP in first day in both group were hypertension is one of major causes of acute stroke with a mean (150.50 ± 48.26 & 145.0 ± 19.97) for study and control group respectively with no significant which had decreased in day 7th.As regard the neurological statue of patient admitted with acute stroke, the result of current study showed that most of patients were very severe stroke with mean of (40.88 ± 0.75 Vs 40.16 ± 2.47) in study.