Stroke.docx - Stroke What IS a STROKE o A stroke is a...

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Stroke What IS a STROKE? o A stroke is a sudden onset of focal neurologic deficit of cerebrovascular etiology lasting >24 hours. Signs and Symptoms o Sudden numbness or weakness of the face, arm or leg, especially on one side of the body o Sudden confusion,trouble speaking or understanding o Sudden trouble seeing in one or both eyes o Sudden dizziness, loss of balance or coordination or trouble walking o Sudden severe headache with no known cause Two Major Types of Strokes o Ischemic strokes 83% of all strokes caused by thrombosis or emboli. o Hemorrhagic strokes 17% of all strokes caused by subarachnoid or intra-cerebral bleeds. Risk Factors for Stroke o Modifiable Factors Hypertension Cardiovascular disease Atrial Fibrillation Diabetes Mellitus Cigarette Smoking Hyperlipidemia Obesity Cocaine use Prior stroke or TIA o Non-Modifiable Factors Age Race Family History ISCHEMIC STROKES o Due to thrombosis, atherosclerosis, or embolism. o Blood supply to an area of the brain is interrupted causing brain tissue in the area to become ischemic. o Atherosclerosis causes arterial stenosis leading to a decreased blood supply. o Embolic strokes are common in patients with chronic atrial fibrillation and patients with prosthetic heart valves. TIA - Transient Ischemic Attacks o Ischemic strokes are sometimes preceded by episodes of transient ischemic attacks (TIAs). o Sudden onset of extremity numbness or weakness o Receptive or expressive aphasia o Diplopia or visual field blindness. o Difference between TIA and stroke is the duration of the symptoms. o Symptoms of a TIA last < 24 hours and there are no residual effects. o Most TIAs last about 10 to 20 minutes. o It is critical that the client seek medical attention even though the symptoms resolve spontaneously. o Warning signs of impending ischemic stroke, require prompt intervention
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o TIAs are often due to stenosis in one or both of the carotid arteries. o Medical treatment includes antihypertensive medications, antiplatelet medications (such as Aspirin or Plavix), an anti- coagulant (Coumadin). Carotid Endarterectomy o If carotid stenosis is established through diagnostic testing, a surgical procedure called a carotid endarterectomy can help restore adequate blood flow to the brain o Early recognition is important! o The sooner the patient gets treatment, the better the outcome! FAST o Facial droop (face is uneven) o Arm is week o Slurred speech (speech is strange) o Time to call 911 Emergency Department Care o Vital signs o Assessment o Primary treatment goals are: restoring cerebral blood flow fluid resuscitation maintaining cerebral oxygenation providing supplemental oxygen o The patient should remain NPO until presence of a gag reflex and swallowing is established.
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  • Spring '14
  • Brinkley

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