Stroke Nursing Theory PDF

NSG 5130: Level III Nursing Theory Med-Surg Week 12: Stroke Learning Objectives Differentiate between ischemic and hemorrhagic strokes Describe health patterns and risk factors associated with stroke conditions. Identify the clinical significance and related nursing implications of the va...

NSG 5130: Level III Nursing Theory Med-Surg Week 12: Stroke Learning Objectives Differentiate between ischemic and hemorrhagic strokes Describe health patterns and risk factors associated with stroke conditions. Identify the clinical significance and related nursing implications of the various diagnostic tests and procedures used for diagnostic assessment of both ischemic and hemorrhagic strokes. Utilize the nursing process as a framework to discuss the care of a client pre, during and post stroke. Assessment (associated clinical manifestations) Nursing diagnoses Goals Implementation: Collaborative care Drug therapy Nursing care Acute care Non-acute care: Health promotion/management  Learning Resources Lewis, S., Bucher, L., Heitkemper, M., Harding, M., Barry, M., Lok, J., Tyerman, J., & Goldsworthy, S. (2019). Medical-Surgical Nursing in Canada – Assessment and Management of Clinical Problems (4th ed.) (Canadian ed.). Toronto: Elsevier Chapter 60 Stroke Stroke = Cerebral Vascular Accident Death of brain cells that occurs when there is (prolonged) ischemia to a part of the brain or hemorrhage into the brain. Functions are lost or impaired. Movement, sensation, emotions that were controlled by the affected area of the brain Severity of the loss of function varies according to the location and extent of the brain involved. (Lewis et. al., 2019 Stroke = Cerebral Vascular Accident Blood flow to the brain is affected by: BP Cardiac output Blood viscosity Without adequate blood flow (oxygen & glucose), neurons can’t function Brain needs at least 20% cardiac output If blood flow is interrupted (ex. cardiac arrest): Neurological metabolism altered within 30 seconds Metabolism stops in 2 minutes Cellular death within 5 minutes (Lewis et. al., 2019 Stroke – Canadian Statistics Third most common cause of death in Canada Behind Cancer and Heart disease Leading cause of serious, long-term disability Approximately 35% of individuals who have an initial stroke die within 1 year Stroke is more common in men Likely to have thrombolytic or embolic stroke Women die more from strokes Likely to have hemorrhagic strokes (Lewis et. al., 2019  Risk Factors Non-Modifiable Modifiable Age Hypertension Gender Diabetes (4-5x risk) Ethnicity and race Heart disease Heredity/family Heavy alcohol consumption history Oral contraceptive use (estrogen) Physical inactivity Smoking (2x risk) (Lewis et. al., 2019 Ischemic Strokes Inadequate perfusion due to partial or complete occlusion of an artery (87% of all strokes) Ischemic Transient Thrombotic Embolic Ischemic Stroke Stroke Attack Ischemic Stroke: Transient Ischemic Attack Transient episode of neurological dysfunction caused by focal brain, spinal cord, or retinal ischemia, without acute infarction of the brain There is no death of brain cells like full strokes Symptoms last