NSG2201: Stroke - Week 8 1.0 PDF

NSG2201: ALTERATIONS TO OXYGENATION, PERFUSION, MOVEMENT & COORDINATION: STROKE Virginia Plummer, 2024 Slides adapted from Brown, Edwards, Buckley & Aitken: Lewis’s Medical–Surgical Nursing © Elsevier Australia, 2020 OFFICIAL ...

NSG2201: ALTERATIONS TO OXYGENATION, PERFUSION, MOVEMENT & COORDINATION: STROKE Virginia Plummer, 2024 Slides adapted from Brown, Edwards, Buckley & Aitken: Lewis’s Medical–Surgical Nursing © Elsevier Australia, 2020 OFFICIAL  OBJECTIVES 1.demonstrate an in-depth understanding of the pathophysiology and clinical manifestations of stroke 2. explain methods and techniques used to conduct a comprehensive nursing history and focused physical assessment, using a systematic primary and secondary survey approach; 3. identify and analyse diagnostic tests and investigations appropriate to diagnose stroke 4. recognise the clinical cues for patient deterioration. 5.. apply a critical analysis of assessment findings and an in-depth understanding of clinical reasoning cycle to develop a therapeutic plan of care for patients experiencing a stroke 6.. outline the collaborative management strategies for patients in the acute care setting and the role of the registered nurse within the team. 7.. examine a range of pharmacological agents used to treat health problems and the impact of polypharmacy on nursing care; OFFICIAL REVISION OFFICIAL Image from Strokeeducation.info OFFICIAL  FANTASTIC RESOURCE: www.informme.org.au 1. Sign up as student 2. Select learning resources 3. Select professional learning modules 4. Select STROKE CARE: an overview for rural and regional nurses 5. Module 1: Brain Anatomy OFFICIAL WHAT IS A STROKE? OFFICIAL  STROKE Occurs when there is disrupted blood supply to brain ISCHAEMIA (inadequate blood flow) to part of brain OR HAEMMORRHAGE into brain that results in death of brain cells Loss of functions such as movement, sensation, emotions depending on affected area of brain Severity of function loss depends on location and extent of brain tissue involved Medical emergency- TIME CRITICAL Brown, Edwards, Buckley & Aitken: Lewis’s Medical–Surgical Nursing © Elsevier Australia, 2020 OFFICIAL  STROKE Second biggest cause of death in Australia and NZ Leading cause of serious, long-term disability 70% stroke occur in people aged >70 yrs old Stroke kills more women than breast cancer and more men than prostate cancer Indigenous Australians and Māori are at higher risk PREVENTION IS THE KEY Brown, Edwards, Buckley & Aitken: Lewis’s Medical–Surgical Nursing © Elsevier Australia, 2020 OFFICIAL  PATHOPHYSIOLOGY OF STROKE ⬤ Brain needs continuous supply of blood to supply oxygen and glucose needed by neurons ⬤ Blood flow must be maintained at 750–1000 mL/minute (55 mL/100 g of brain tissue), which is 20% of cardiac output ⬤ CEREBRAL AUTOREGULATION ⬤ If cerebral blood flow interrupted (e.g. cardiac arrest), neurological metabolism is altered in 30 seconds, stops in 2 minutes and cellular death occurs in 5 minutes Brown, Edwards, Buckley & Aitken: Lewis’s Medical–Surgical Nursing © Elsevier Australia, 2020 OFFICIAL PATHOPHYSIOLOGY OF STROKE Two major pairs of arteries supply the brain ⮚ Internal carotid (anterior circulation) ⮚ Vertebral arteries (posterior circulation) OFFICIAL WARNING SIGNS OF STROKE? OFFICIAL OFFICIAL  RISK FACTORS FOR STROKE Non-modifiable Modifiable ⬤ Hypertension ⮚ Stroke risk doubles each ⬤ Smoking decade after 55 ⬤ Heart disease ⬤ Serum cholesterol ⮚ More common in men; ⬤ Excess alcohol consumption more women die ⬤ Obesity ⬤ Sleep apnoea ⮚ Higher incidence in ⬤ Metabolic syndrome Indigenous Australian and ⬤ Lack of physical exercise Māori population ⬤ Poor diet ⮚ Heredity/family history ⬤ Substance abuse OFFICIAL  ISCHEMIC STROKE TYPES OF STROKE 85% of strokes are ischemic TIA usually a precursor thrombotic or embolic OFFICIAL  TRANSIENT ISCHEMIC ATTACK (TIA) transient episode of neurological dysfunction caused by ischemia without acute infarction of the brain ‘mini stroke’ WARNING SIGN Symptoms typically last < 1hour (