Ischemic stroke
What is the cause of an Ischemic stroke?
Sudden loss of function resulting of disruption of blood supply to a part of the brain.
What is the cause of an hemorrhagic stroke?
Caused by bleeding into the brain tissue, the ventricles, or the subarachnoid space.
What is Tissue Plasminogen Activator (TPA)?
Blood thinner that is used to dissolve blood clot that block blood flow to the brain.
What is the acronym for identifying and reporting a stroke ? what do each letter stand for?
F-A-S-T:
-Facial drooping
-Arm weakness
-Speech difficulties
-Time
Name one kind of Ischemic Stroke
Answer options: Large artery thrombosis, small penetrating artery thrombosis, cardiogenic embolism, and cryptogenic.
What kind of Hemorrhagic stroke is characterized by bleeding into the brain tissue, most commonly with patients who have hypertension and cerebral atherosclerosis?
Intracerebral Hemorrhage
What type of medication are patients sent home with to decrease the risk of another intracerebral hemorrhage?
Patients are normally required to take antihypertensive medications after discharge.
What are the main symptoms differences between Ischemic and Hemorrhagic stroke?
Ischemic stroke symptoms are numbness or weakness of the face, arm, or leg (especially on one side of the body), aphasia, and vision loss. Hemorrhagic symptoms are complains of " worst headache of my life", decreased level of consciousness, and seizures.
What are the clinical manifestations of Ischemic stroke?
Unilateral numbness or weakness of face, arm, or leg.
confusion or change in LOC
Dysarthria
Aphasia
sudden, severe headache
What are the potential complications of a patient with a hemorrhagic stroke?
If the bleeding in a patient is caused by an anticoagulation with warfarin, what medication will the nurse be expected to administer?
The nurse would administer fresh-frozen plasma and Vitamin K.
To realize the full potential of early intervention, community education directed at recognizing the symptoms of stroke and obtaining appropriate emergency care is necessary to ensure rapid transport to a hospital and initiation of therapy within the recommended 3-hour period.
What are the Nursing interventions for Ischemic Stroke?
What are the Nursing interventions for Hemorrhagic stroke?
Optimizing cerebral tissue perfusion; implementing aneurysm precautions
Relieving anxiety
Monitoring and managing potential complications
Patient and family education
If the patient remains immobile after 1 to 4 days from the onset of the hemorrhage and there is documentation that the bleeding has been resolved, the nurse may give which medication?
The nurse may give prophylactic DVT medications such as low-molecular-weight or unfractionated heparin.
Name a diagnostic test for Strokes
CT scan
MRI scan
Cerebral Angiography
Lumbar Puncture (if CT is negative and ICP is not elevated to confirm subarachnoid hemorrhage)
This neurological test may be performed on a patient who is suspected to have agnosia from an ischemic stroke.
(Hint: we learned this in adult health assessment)
Stereognosis test
Which patient below is most at risk for a hemorrhagic stroke?
A. A 60 year old male patient with carotid stenosis.
B. A 86 year old female with atherosclerosis.
C. a 90 year old male with uncontrolled hypertension and a history of brain aneurysm repair 2 years ago.
D. A 52 year old female with atrial flutter.
C.
Rationale: Risk factors for an hemorrhagic stroke is uncontrolled hypertension, history of brain aneurysms, and old age.
What medication reduce coronary events and ischemic strokes?
Statins
This scale, composed of various evaluations, is used to determine the severity of a patient's stoke.
National Institutes of Health Stroke Scale (NIHSS)