Assessment
Patient presenting with aphasia, right hemiparesis, right hemisensory loss, right visual deficit, left gaze deviation
What is Left Cerebral Hemispheric Ischemic Stroke?
Action taken for a Stroke patient presenting with labored respirations & decreased LOC
What is Airway intervention, intubation?
In addition to paging the Neurologist on call, stroke patients presenting to the ED with an increased NIHSS score will have this test ordered to rule out a hemorrhagic stroke.
What is a stat CT brain?
For Ischemic stroke patients, this must be administered within 4.5 hours.
What is TPA?
Patient presenting with right gaze deviation, left hemi-inattention & hemiparesis, left hemisensory, left visual field defect
What is Right Cerebral Hemispheric Ischemic Stroke?
Action taken if patient displays drowsiness, severe headaches, Nausea & vomiting, acute hypertension following IV t-pa administration/infusion
What is Stop the IV t-PA infusion?
Hypertension, use of oral contraceptives, smoking, drug abuse, alcohol abuse
What is risk factors for stroke?
Ischemic stroke patients with current or previous history of Afib/Aflutter must be discharged with this class of medication.
What is Anticoagulant?
Patient presenting with Nausea & Vomiting, pounding headache, & decreased consciousness
What is Hemorrhagic Stroke?
Patient presents with Increased Systolic Blood pressure, Bradycardia, and irregular respirations
What is late sign of increased ICP, call a rapid and provider.
People find it very difficult to find or say the right words, although they probably know exactly what they want to say.
What is expressive aphasia?
Neurologic examination stroke scale to evaluate the effect of acute cerebral infarction on the levels of consciousness, language, neglect, visual-field loss, extraocular movement, motor strength, ataxia, dysarthria, and sensory loss.
What is the NIHSS?
Dizziness, confusion, headache
Concussion
Hemorrhage on CT, Patient was last seen normal 24 hours ago, NIH Stroke scale score of 0, pt is on regular anticoagulants
What are contraindications for administration of t-PA
Someone is able to speak well and use long sentences, but what they say may not make sense. They may not know what they are saying is wrong and they become frustrated.
What is receptive aphasia?
Before PO intake, we must perform this screening on our stroke patients.
What is a dysphagia screening?
Triggered by distended bladder, sudden increase in BP, sweating, and bradycardia
Place patient on continuous ECG Monitor, Monitor Blood Pressure, Perform NIHSS, Perform Dysphagia Screening
What are 4 Actions taken stroke patients?
Swallow evaluations should be performed by this individual.
Who is the speech therapist?
The education we should provide our stroke patients and their families.
What are 1. Signs and symptoms 2. Discharge Medications 3. Individual risk factors 4. Follow up appointments 5. When to call EMS?