Stroke (1)

Stroke (CVA) (Brain Attack) NUR 211: Health Care Concepts Unit Four - Module 4C Part 1

Learning Outcomes: ● Collaborate with the interprofessional team to coordinate high-quality care for patients experiencing a stroke (brain attack). ● Implement nursing interventions to help the patient and family cope with the psychosocial impact caused by a stroke (brain attack). ● Apply knowledge of anatomy, physiology, and pathophysiology to assess patients experiencing a stroke (brain attack). ● Use clinical judgment to plan care for patients experiencing a stroke. ● Teach the patient and caregiver(s) about common drugs for a patient experiencing a stroke (brain attack).

Learning Resources ● Ignatavicius, D. (2021). pp. 898-912 ● Ignatavicius, D. (2021). Study Guide. Chapter 41 (questions 1-17) ● Silvestri, L. (2023). pp 864-865 ● ATI RN Adult Medical Surgical Nursing 11.0 - Chapter 15 ● ATI RN Pharmacology for Nursing 8.0 - Chapter 25

Stroke “Disruption of cerebral blood flow”

Incidence & Prevalence ● Fifth leading cause of death in the US ● Women have a higher incidence than men ● “Stroke Belt” ● Many survivors

Transient Ischemic Attack (TIA) ● “Warning Sign” ● Brief interruption of cerebral blood flow ● Symptoms resolve quickly

Types of Strokes ● Ischemic ○ Thrombotic ○ Embolic ● Hemorrhagic ○ Intracerebral hemorrhage (ICH) ○ Subarachnoid hemorrhage (SAH) ○ Aneurysm ○ Arteriovenous malformation (AVM)

Thrombotic Stroke ● Blood clot due to plaque ● Shuts off the artery ● Ischemia distal to occlusion ● Symptoms progress ● Usually, no LOC changes

Embolic Stroke ● Embolus travels ● Blood flow shut off ● Sudden severe symptoms ** ● Few warning signs ● Remains conscious ● Atrial fibrillation is a major risk factor

Hemorrhagic Stroke ● “Bleeding” ● Sudden ● Altered LOC ● Headache ● Poor prognosis

Risk Factors ● TIA ● Hypertension ● Cocaine Usage ● Diabetes ● Smoking ● Atrial fibrillation ● Cerebral aneurysm ● Obesity ● Atherosclerosis ● Hyperlipidemia ● Hypercoagulability ● Use of oral contraceptives

Health Promotion and Maintenance ● ABCs: ○ Aspirin use when appropriate ○ Blood pressure control ○ Cholesterol management ○ Smoking cessation

Stroke Prevention ● Medications ○ Anticoagulants ■ Warfarin ■ Apixaban ■ Rivaroxaban ○ Antiplatelets ■ Aspirin ■ Platelet Inhibitors ● Dipyridamole ● Clopidogrel ● Procedures ○ Carotid endarterectomy ○ Extracranial-intracranial bypass

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