What is a stroke?
Interruption of perfusion to any part of the brain resulting in infarction (cell death).
What determines severity of a stroke?
Location and extent of brain involvement.
How fast does brain metabolism change after blood flow stops?
Altered in 30 sec, stops in 2 min, cell death in 5 min.
How many brain cells are lost per minute during a stroke?
1.9 million brain cells/min.
What is a TIA?
Temporary ischemia <1 hour, no cell death.
Symptoms of a TIA
Visual, mobility, sensory, or speech changes.
Types of stroke
Ischemic & Hemorrhagic.
Ischemic stroke definition
Blockage of blood flow (thrombus/embolus).
Hemorrhagic stroke definition
Bleeding into brain tissue or subarachnoid space.
Common stroke risk factors
HTN, DM, smoking, obesity, high cholesterol, family history, atherosclerosis.
Modifiable stroke prevention strategies
BP control, cholesterol management, ASA use, smoking cessation, physical activity, healthy diet.
Key history question during stroke assessment
“When was the patient last seen normal?”
Essential imaging for stroke
CT scan (rule out hemorrhage before tPA).
Key stroke assessment tools
FAST; NIH Stroke Scale; Canadian Neurological Scale.
FAST meaning
Face drooping, Arm weakness, Speech difficulty, Time to call 911.
General stroke symptoms
Unilateral weakness, facial droop, speech changes, vision loss, numbness, confusion.
Primary cause of neurologic deficits in stroke
Location of infarct.
Priority nursing hypothesis in stroke
Inadequate cerebral perfusion.
Other stroke-related nursing diagnoses
Decreased mobility; Aphasia/dysarthria; Sensory perception deficits.
Goal of cerebral perfusion therapy
Restore blood flow ASAP.
What is tPA (alteplase)?
Fibrinolytic that dissolves clots.
tPA must be given within what time frame?
Within 4.5 hours of symptom onset.
Before giving tPA, what must be ruled out?
Hemorrhagic stroke (via CT scan).
Door-to-needle time goal for tPA
<60 minutes.
