stroke
- A sudden attack of weakness or paralysis occurs when blood flow to an area of the brain is interrupted
- death of brain cells that occurs when there is ischemia to a part of the brain or hemorrhage into the brain
- Damage is irreversible
ischemic stroke
- The most common type of stroke in older people
- occurs when the flow of blood to the brain is blocked by the narrowing or blockage of a carotid artery.
- 83% of strokes are ISCHEMIC
hemmorragic stroke
- bleeding into the brain tissue or subarachnoid space
- 17% of strokes are hemorrhagic
Transient Ischemic Attack (TIA)
- a temporary focal loss of neurological function caused by ischemia of one of the vascular territories of the brain
- lasting less than 24 hrs, often lasts less than 15 minutes
- Effects:
motor
sensory
speech/language
vision
cerebellar disturbances
Risk factors for stroke
- Hx of TIA
- Prior stroke
- Old age
- High blood pressure (HT)
- Smoking or tobacco use
- Diabetes
- Overweight or Obesity
- Excessive alcohol
- Certain medications (stimulants)
- Inactivity
- Atherosclerosis
- Heart disease
- Atrial fibrillation (Afib)
- Blood disorders
Right side of brain
controls emotional expression
spatial perception
recognition of faces
patterns
melodies,
- Creativity
- Imagination
- Music and Arts
- A patient with a right-side stroke may suffer from emotional lability, which includes involuntary outbursts of emotion - a right-brained task.
Left side of brain
- Logic
- Analysis
- Sequencing
- Mathematics
- Language
- Critical thinking
- Reasoning
- Thinking in words
- A patient with left-side stroke may suffer from aphasia, the inability to understand or express language - a left brain task.
Signs and symptoms of a stroke
- paresthesia (numbness, tingling, burning)
- Weakness or paralysis of the limbs
- Aphasia (impairment of language expression and understanding)
- Confusion
- Visual Disturbance in one or both eyes
- Dizziness
- Loss of balance and coordination
- headache
Early warning signs of a stroke
- balance issues
- eyesight issues
- facial drooping
- arm weakness
- slurred speech
- co-ordination
- dizziness
- headache
- paresthesia (numbness, tingling, burning)
- Hemiparesis
weakness of one entire side of the body
- Hemiplegia
complete paralysis of half of the body
- Aphasia
an impairment of language, affecting the production or comprehension of speech and the ability to read or write
- Dysarthria
difficult or unclear articulation of speech. It results from impaired movement of the muscles used for speech production, including the lips, tongue, vocal folds, and/or diaphragm.
- Dysphagia
difficulty or discomfort in swallowing
- Apraxia
a motor disorder where the patient has difficulty with the motor planning to perform tasks or movements despite intact motor function.
- Homonymous hemianopia
a condition in which a person sees only one side―right or left
- Horner Syndrome
caused by the disruption of a nerve pathway from the brain to the face and eye on one side of the body. Normally, patients with Horner syndrome have the following- decreased pupil size, a drooping eyelid and decreased perspiring on the affected side of the face.
- Agnosia
inability to interpret sensations and hence to recognize things
- Unilateral neglect
failure to report or respond to stimuli presented from the contralateral space, including visual, somatosensory, auditory, and kinesthetic sources
Medical interventions for stroke
- Early diagnosis
- Maintain cerebra oxygen
- Restore cerebral flow
- Prevent complications- bleeding, cerebral edema
- Prevention of a second stroke
- Rehabilitation- focus on maximizing patients physical and cognitive recovery
- Patient and family education
Nursing interventions for stroke
Nurse:
- Frequent neurological assessments
- Fall prevention measures
- Prevent aspiration
- HOB at 30 degrees (increase venous return)
- initiate DVT prophylaxis (mechanical & chemical)
- Prevent edema
- Facilitate safe swallowing
- Monitor vital signs
- prevent skin breakdown
- regular position changes in bed
- ambulate the pt standing on their weaker side
For patient:
Teaching/ education on:
- assistive ambulatory devices
- nutrition
- rehab
- promote family coping and communication
treatment of TIA’s
antiplatelet agents reduces the risk of stroke
treatment for ischemic stroke
TPA (tissue plasminogen activator) should be administered within 4.5 hours
FAST
FACE
ARMS
SPEECH
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