STROKE
Types of strokes
What are hemorrhagic and ischemic
Your patient has arrived from the ED and has had a stroke... There is a diet order for a soft diet, but you do not see a completed bedside swallow screening by an RN or speech therapist. Your patient is hungry. Your next step should be
What is complete a bedside swallow screening.
It is important to wake up a patient for neuro checks. True or False
What is TRUE?
Stroke Core Team Members
neurologist, house supervisor
stroke coordinator
charge nurse
bedside RN
We must offer and document this education patients who smoke.
What is smoking cessation education
Acronym for stroke and meaning of each letter
What is BE FAST; B- balance; E- eyes; F- face; A -arm; S- speech; T -time
RN's on these units may administer TPA
What is ED, CCU, and ICU registered nurses
A potential stroke patient will get to CT accompanied by this member of the Rapid Response Team
What is the nurse?
For an inpatient with new onset of stroke symptoms. This is the goal time from symptom to NIHSS completion
What is 15 minutes?
Stroke patient education is conducted by these
What is the nurse individualizes the education and care plan.
Most definitive test for a stroke
what is a CT scan
It is the goal time for CT results from onset of symptoms to results obtained for a patient that is already in the hospital.
What is Onset to CT results obtained < 45 minutes
Neuro checks are documented on this flowsheet in Epic
What is the neuro assessment flowsheet?
Patient cannot take heparin as part of his treatment for stroke what can be used instead
what is SCD
A patient with an cardio-embolic (AFib) ischemic stroke is to be discharged with what medication to take at home?
What is Coumadin, unless a contraindication exists and is documented
If an inpatient is having the signs/symptoms of an acute stroke staff get assistance by this action
What is activate an Rapid Response Team indicating a possible stroke
These medical personnel can perform a bedside swallow screen
What is a bedside nurse, physician, or a speech therapist
Frequency of NIHSS on Med/surg units
What is ONCE per shift
An hospital-based quality initiative developed by the AHA and ASA to improve the care of patients with cardiac diseases and stroke
What is Get With The Guidelines (GWTG)
Items that require education and documentation for discharge
What is • How to activate EMS when a pt. suspects something is wrong
Follow-up after Discharge • Discharge Medications • Risk Factors in general and the Patient’s specific risk factors • Warning s/s and chances of re-stroke • Explanation of ALL medications and diagnostic tests prior to being done.
An RRT has been activated for your patient for a possible stroke. Your next step is to assess the following and take what steps?
What is vital signs and blood sugar. Await the run nurse assistance with NIHSS or charge nurse begin NIHSS. Be prepare for patient transport to CT
A treatment strategy that involves temporarily keeping a patients blood pressure elevated after a stroke or cardiac surgery
What is permissive hypertension
Gold standard for assessment of stroke
What is NIHSS
Eight stroke core measure
What are: (1) VTE prophylaxis (2) dc on antithrombotic therapy (3) Anticoagulation therapy for Afib/Aflutter (4) stroke education (5) antithrombotic therapy by the end of hospital day 2 (6) dc on statin medication (7) stroke education (8) Assessment for rehabilitation
A patient with an non- cardio embolic ischemic stroke be discharged on this agent (medication) to take at home
What is Anti-platelet (Aspirin, Plavix), unless a contraindication exists and is documented