-Stroke-”Brain Attack”

Goal:The purpose of this presentation is to provide registered nurses with the education to care for a patient who has had a stroke

Objectives:•Identify common risk factors related to patients experiencing a cerebral vascular accident.•Identify clinical manifestations associated with cerebral vascular accident.•Identify interventions and nursing care for stroke patients.

2 Types of strokes: Ischemic: blockage of blood supplyHemorrhagic: blood vessel rupture

NON-MODIFIABLE MODIFIABLE

Smoking Elevated cholesterol Poor diet Lack of exercise Hypertension Diabetes Excess alcohol Previous TIA, CVA, or MI

Age Hereditary factors Race or ethnicity Patent foramen ovale Sickle cell disease

Asymmetrical facial droopUnilateral weakness or numbness Unilateral visual disturbances Decreased level of consciousness Sensory alterations Nausea and vomiting HeadacheVertigoAbnormal respirations

Symptom assessment/brief history Neurological assessment Labs: CBC, platelet count, PT, PTT,

metabolic panel and urinalysis CTEKGAdditional tests

Vital sign monitoringMonitor neurological statusMonitor for bleeding complicationsKeep patient’s airway patentEvaluate swallowingTeach patient/family to avoid

complicationsEducate patient of risk factors to prevent

additional stroke

FDA approved treatment to restore blood flow

Does not stop stroke from occurring but can minimize the area of infarction

Ischemic strokes onlyMust be at least 18 years oldNeurological deficit presentOnset of symptoms less than 3 hours

Aphasia Muscle weakness (hemiparesis)Sensory lossUnilateral neglectHomonymous hemianopsia

Cross, S. (2008). Stroke care: a nursing perspective. Nursing Standard, 22(23), 47. Retrieved from EBSCOhost.

Harvey, Joan (2004). Countering brain attacks. Nursing Management, 27-32, Retrieved from www.nursingmanagement.com

Murphy, J. (2003). Pharmacological treatment of acute ischemic stroke. Critical Care Nursing Quarterly, 26(4), 276-282. Retrieved from EBSCOhost.

Willoughby, D., Sanders, L., & Privette, A. (2001). The impact of a stroke screening program. Public Health Nursing, 18(6), 418-423. Retrieved from EBSCOhost.