Risk factors
HTN
Prevention
Antihypertensive medication
Stop smoking
Manage hyperlipidemia
Controlled diabetes
Aspirin
CVA treatment
- slowly decrease hypertension to prevent hypotension
Signs and symptoms of TIA
Facial droop
Arm drift
Speech impairment
Hemiparesis
Time is of essence (1 hour)
Signs and symptoms of hemorrhagic stroke
severe, sudden headache
diplopia
vomiting w/o nausea
Signs and symptoms of left sided stroke
Language and logic
- dysphasia
- reading/writing problems
- RT hemiparesis & neglect
Signs and symptoms of right sided stroke
Reckless and Creative
- lack of impulse control
- behavioral changes
- LT hemiparesis & neglect
- visual and spatial deficits
Treatment for TIA
- thrombolytics w/in 4-5 hours of onset
- alteplase, streptokinase, tPA
Treatment for hemorrhagic stroke
- implement seizure precautions
- enforce bedrest, prevent sensory overload
- no blood thinners (aspirin, clopidogrel, heparin, warfarin, thrombolytics)
- HOB elevated
- administer stool softeners daily
- cluster care
Patient education for hemianopsia
- dress and apply clothes on weaker side first
- turn head to affected side and scan room completely
- approach from unaffected side
- transfer client with stronger side first
- improve independence and resume former strength
Patient education for RT sided injury
- behavioral changes to decrease confusion and anxiety
- maintain safety
Priority for stroke treatment
airway protection
- dysphagia, GERD
Broca’s aphasia
making speech is impaired
Wernicke aphasia
understanding is impaired
NIH stroke scale
- LOC
- what is the month and your age
- open and close eyes
- open and close hands
- best gaze
- visual
- facial palsy
- motor arm
- motor leg
- limb ataxia (finger to nose, foot to shin test)
- sensory
- best language (describe situation & identify pictures)
- slurring
- extinction and inattention (neglect)
