Stroke Symptoms
What is the acronym we use to identify signs and symptoms of stroke?
BEFAST
How do you activate a code stroke?
Dial 88, ask for a code stroke and give them your exact location including facility.
Patients are only eligible to receive IV TNK if they are within ___ hours of their last known well time
4.5
How does aspirin reduce the risk of recurrent stroke?
Aspirin prevents platelets from binding together and to stenotic arteries.
A patient with left hemiplegia and right gaze likely has a _____ hemispheric stroke.
Right
Your patient suddenly develops difficulty walking and dizziness. Which letter of BEFAST is your patient exhibiting?
B - Balance
What is the only lab test you should include for your patient who you suspect is having an acute stroke?
Blood glucose
This is a invasive endovascular procedure for stroke patients with large or medium vessel occlusions with a goal of clot removal
Mechanical Thrombectomy
How does a statin reduce the risk of recurrent stroke?
Statins work by reducing over all cholesterol levels, especially the LDL. LDL cholesterol contributes to plaque formation and atherosclerosis --> increasing the risk of stroke. Goal LDL is <70.
A patient with aphasia and right hemiparesis, likely has a _____ hemispheric stroke.
Left
You patient starts drooling and keeps dropping their coffee cup. What two letters of BEFAST is your patient exhibiting?
F - Face
A - Arm
When should you call a code stroke?
If your patient develops any new stroke-like symptoms, you should call as soon as you detect them
What are two types of occlusions that may benefit from mechanical thrombectomy?
Large and medium vessel occlusions
Why does a patient with atrial fibrillation require anticoagulation?
Atrial fibrillation increases the risk of clot formation in the atria of the heart due to blood stasis. Anticoagulants interrupt the clotting cascade and prevent clots from forming --> decreased risk of stroke.
A patient that has ataxia and a right or left visual field cut, likely has a _____ stroke.
Cerebellar
Your patient will only look toward the left and sounds confused. When you ask him to identify a pen he calls it a "write". What two letters of BEFAST is your patient exhibiting?
E - eyes
S - speech
What imaging tests should you anticipate to be ordered?
CT head without contrast
CTA head/neck
Possibly CTA/P and MRI brain
Patients be within ___ hours of their last known well time to be a candidate for mechanical thrombectomy.
24
What lifestyle modifications can you help your patient to learn?
Mediterranean diet, decrease alcohol consumption, reduce/quit smoking, exercise.
MEDICATION COMPLIANCE
A patient that has diplopia, difficulty staying awaying, dysphagia, a drooping eye lid and large pupil, facial droop on the right and arm weakness on the left likely has a ______ stroke.
Brainstem
How many brain cells do you lose per second of an acute ischemic stroke?
32,000
Where is your green code stroke book?
There are green code stroke books located at the nursing stations of each floor and the therapy gym.
Your patient is admitted to rehab following a stroke 3 weeks ago. Are they a candidate for IV thrombolytics?
No - patients who've had a stroke within 3 months are not a candidate due to increase risk of hemorrhage.
What role does blood pressure play for stroke patients?
Hypertension: over time it increases the risk of vessel damage and your stroke risk. However in the acute phase for ischemic stroke we allow hypertension to increase perfusion.
Hypotension: decreases perfusion to the brain and increases. Will be required for post-ICH patients.
A patient has a right sided weakness of the upper and lower extremity, but does not have any aphasia. The patient likely has a _____ stroke.
lacunar stroke in the left basal ganglia.