What is the common presentation of ischaemic stroke?
Droopy face, weakness in arms, jumbled speech
What is the common presentation of haemorrhagic stroke?
Droopy face, weakness in arms, jumbled speech
How to diagnose an ischaemic stroke?
CT scan
How to diagnose an haemorrhagic stroke?
Catheter takes images with contrast medium to locate bleeding
How to complete a nursing history for a stroke?
- Current situation
- History of similar symptoms
- Current medications
- Risk factors
- Associated illnesses such as hypertension
- Family history of stroke
What are the functional health patterns of stroke?
- Cognition – perceptual
- Activity – exercise
- Nutrition – metabolic
- Health perception & health management
- Elimination
Treatment and medication for ischaemic stroke?
Removal of clot through surgery
- Anti-platelet
- Anti-coagulant
- Anti-hypertensive
Treatment and medication for haemorrhagic stroke?
Coils fill bleeding Open skull surgery with metal clip attached to bleeding point - Anti-platelet - Anti-coagulant - Anti-hypertensive
What does hemiplegia mean?
Paralysis of left or right half of the body
What does aphasia mean?
Difficulty speaking (e.g. omission of small words or changing word order)
What does dysphasia mean?
Impaired ability to communicate, incomprehensible speech or inability to understand speech
What does dysarthria mean?
Disturbance to muscular control affecting speech/pronouncing words
What does unilateral neglect mean?
Unaware or inattentive to one side of the body
What does hemianopia mean?
Loss of half of the vision field in one or both eyes
What does agnosia mean?
Inability to recognise previously familiar objects
What does diplopia mean?
Unilateral or bilateral double vision
What does dysphagia mean?
Difficulty swallowing
What are some nursing interventions?
- Nutritional (assessment of nutritional needs within 72 hours of admission)
- Activity (assessment for devices to support mobility)
- Cognition (assessment for communication and neurological difficulties)
- Elimination (assessment for bowel difficulties)
- Health perception & health management (assessment for self-management, education gaps and adhering to therapy)
How are anti-platelets used for stroke?
Decreased platelet aggregation and inhibit thrombus formation. This is by decreasing the ability for blood to form clots by influencing the platelet activation process
How are anti-coagulants used for stroke?
Reduce blood ability t coagulate and prolong the clotting time. They are similar to anti-platelets but anti-coagulants inhibit the coagulation cascade after initial platelet aggregation
How are anti-hypertensives used for stroke?
Lower blood pressure which lowers risk of stroke and secondary stroke
What are the different types of anti-hypertensives?
- Thiazide diuretics
- Ace inhibitors
- Beta blockers
- Calcium channel blockers
- Angiotensin II receptor antagonists (ARBs)
What stroke is Aspirin used for, and what is the effect and rationale?
- Ischaemic stroke
- Effect - anti-platelet aggregator and anti-inflammatory
- Rationale - Aspirin can be used as an adjunct in thrombolytic therapy with Clopidogrel and Dipyridamole
What stroke is Clopidogrel used for, and what is the effect and rationale?
- Ischaemic stroke
- Effect - inhibits the role of ADP in platelet aggregation
- Rationale - management of thrombotic disorders
