Free Essay

Stroke

In: Science

Submitted By annbert5
Words 3810
Pages 16
NURSING MANAGEMENT OF A
STROKE PATIENT

INTRODUCTION
Stroke is the only largest cause of adult disability which leaves a devastating and lasting effect on people and their families (DoH, 2007a). The government of the United Kingdom had recognized stroke as a health care priority. Several government agencies developed clinical guidelines which are being implemented today in local health care settings (Williams et al, 2010a). This essay will focus on stroke as the cause of impaired mobility and will tackle on the patient-centered rehabilitation care plan along with its evidence-based rationales. Health and social care policies and its effect on the patient’s chosen journey will also be discussed.

PATIENT PROFILE
This is a case of a 68 year-old, married female who lives in the south of England. Mrs. G was admitted on 12 October 2010 with a presenting complaint of left-sided weakness. Prior to admission, she experienced persistent pain on the back of the head for 2 days, which was unrelieved by Paracetamol intake. On the morning of admission, she collapsed in the bathroom and was found by the husband after 3 hours. She was brought to the hospital via ambulance and upon initial assessment, no shortness of breath, slurred speech, dizziness, palpitation and chest pain were noted. Her vital signs were as follows: blood pressure of 169/59 mmHg, pulse rate of 80 bpm, respiratory rate of 18 breaths per minute, body temperature of 37.5 degrees Celsius, Glasgow Coma Scale of 15, blood sugar level of 5.2 mmol/L, oxygen saturation of 100% on room air. Neurologic assessment revealed neglect on left lateral vision and mild mouth droop. Her laboratory test showed a 0.55 ug/L Troponin I level, an indication of an acute infarct. A small left ventricle cavity size with impaired systolic function was also noted on her echocardiogram. Her past medical history includes hypertension and bladder problems, with non-compliance to Atenolol, Simvastatin and Aspirin. Mrs. G lived with her husband and was independent with activities of living prior to stroke.
In the course of her treatment, Mrs. G underwent series of sessions with the multi-disciplinary team. Her medication management involved daily intake of Aspirin, Atenolol and Simvastatin (RCP, 2000a)). It was found out that people presenting with acute stroke should be given Aspirin and stroke patients who are already receiving Statins should continue their Statin treatment (NICE, 2008).

PATHOPHYSIOLOGY
Mrs. G’s physical disability was due to her left-sided weakness brought about by an ischaemic stroke attack. A stroke is a prolonged interruption in the blood flow through one of the arteries supplying the brain. Hemiplegia or paralysis of one side of the body is a common neurologic product of cerebrovascular accident or stroke.
The motor area on Mrs. G’s right side of the brain incurred an infarct resulting to left-sided hemiplegia as manifested by flaccidity of left arm and left leg. An ischaemic stroke occurs when a thrombus or embolus blocks an artery carrying blood to the brain. Cerebral ischaemia happens when glucose and oxygen to the brain are reduced. The glucose reduction quickly depletes the supply of adenosine triphosphate resulting to anaerobic cellular metabolism and accumulation of toxic by-products such as lactic acid. Oxygen depletion on the other hand, triggers the release of neurotransmitter glutamate which activates N-methyl-D-aspartate neuronal transmitters. These transmitters make it possible for calcium and glutamate to enter the cells in large amounts, causing chaos and the release of free radicals which destroy the brain cells. This assault extends to the zone of cerebral infarction (Timby and Smith, 2003).
Hypertension and a high cholesterol level are risk factors of stroke which were evident in Mrs. G’s medical history. These were managed according to clinical guidelines which include lifestyle change and drug therapy (DoH, 2007b).

ASSESSMENT
The framework used for assessment was the Roper-Logan-Tierney model of nursing which is based on activities of living. This framework promotes independence through complete assessment leading to interventions that sustain patient’s functionality (Roper et al, 2000). Mrs. G’s ability to function was compromised due to her left-side paralysis, which was the reason this framework for assessment has been utilized for this care plan.

Assessment through activities of living:
Maintaining a safe environment
One pre-requisite of rehabilitation is to provide a safe environment for the patient (Healthtree, 2010). As assessed, Mrs. G was conscious, coherent and fully orientated to time, place and person. Her Glasgow Coma Scale was 15/15, blood pressure at 128/79 mmHg and pulse rate of 68 bpm. Although she had normal visual acuity and pupillary size, there was mild neglect on her left lateral vision and weakness on her left side of the body, which made her susceptible to injury and falls.
Communicating
For some stroke patients, their ability to communicate improved quickly during recovery, but there were also some who were left with communication difficulties which required professional help (Healthtalkonline, 2010). Luckily, this patient had no slurred speech or aphasia, nor problems with comprehension. She used the call bell to get help from staff on bay and also socialized with other patients in the ward.
Breathing
Some patients may experience breathing difficulties after stroke (Stroke foundation, 2010). But for Mrs. G, she was not in respiratory distress and was saturating at 100% on room air. There was equal, bilateral chest movement and showed nasal breathing upon inspection. Respiratory rate was at 18 breaths per minute.
Eating and Drinking
Dysphagia is common after stroke, or sometimes patients do not feel the food or water in the mouth (Rhodes, 2009). Although Mrs. G had left side paralysis, her mastication and swallowing ability were not affected. She had a good appetite and was able to eat using her good hand. She was on a low salt, low fat diet.
Eliminating
Bowel problems post stroke may be expected because part of the brain that controls waste removal may have been damaged (NSA, 2009). In Mrs. G’s case, she was continent of both urine and stool and mobilized with the aid of a quad stick to the toilet, with assistance of one person.
Personal Cleansing and Dressing
Hygiene and grooming are part of self-respect (Alexander et al, 2000). Mrs. G was assisted in washing and dressing by providing her a commode chair where she sat while she was supported in cleansing and reminded to care for the weak side of the body.
Controlling Body Temperature
Body temperature control is often disrupted once brain stem stroke occurs (SRA, 2009). As Mrs. G did not suffer from this type of stroke, she remained apyrexic at 36.6 degrees Celsius throughout the periods of assessment. In the mornings, she had physiotherapy exercises and kept herself hydrated by frequent oral fluid intake. At night, she was kept warm by wearing pajamas and three blankets over the cover sheet.
Mobilising
Early mobilization may contribute to improved outcome after stroke (Bernhardt, J. et al, 2008). Mrs. G was able to mobilize early on. However, the major issue was her impaired mobility because it affected her activities of living. While standing, Mrs. G was wobbly even with the use of a quad stick. She was also scared to walk because she was afraid to fall. Due to this unsteadiness, she required a one-person assist in mobilising and transfers.
Working and Playing
For some stroke survivors, getting back to work might be a different experience (NHS-GGC, 2010). But for Mrs. G, it has never been a problem since she has been a devoted housewife to her retired teacher-husband. She was however, an active participant in church activities before her stroke.
Expressing sexuality
The stress that comes with stroke can cause depression and may affect the patient’s sexuality (Vega, 2008). During assessment, Mrs. G manifested her own sense of sexuality by daily grooming which included choosing her clothes for the day, brushing her hair and applying lipstick. She has been married for 48 years, had menopause at the age of 50 and had been sexually inactive since then.
Sleeping
Sleep contributes to the stroke patient’s recovery by strengthening the brain (Cheow, 2010). This was apparent with Mrs. G who always slept 8 to 9 hours per day. She slept with one pillow under the head and another one for the weak arm. Part of her bedtime routine was having tea before dozing off.
Dying
Fear of death associated with stroke is common not only to patients, but to all people in general (SRO, 2010). For Mrs. G, She had accepted it to be a part of everyone’s journey and yet, there was an inner fear of leaving her family behind. She had no living will.

IDENTIFICATION OF PATIENT’S PROBLEM
Among all the problems Mrs. G had during assessment, mobility problem was the most important because it affected her activities of living. Therefore, the focal point of the care plan was on impaired mobility with enhancement on rehabilitation. After all, mobility rehabilitation plays a vital part in the overall treatment of stroke and one in which a nurse has a central role (Williams et al, 2010b).

CARE PLAN Identified Problem Interventions Rationales References

Impaired
Mobility

1.Assessed for functional ability

2.Accomplished Inpatient Faller Identification Tool

3.Assisted and reminded of proper walking techniques using a quad stick

4.Assisted in washing and dressing; encouraged to partake in activity

5.Encouraged to stand and undertake periods of weight bearing

6.Educated patient and relative regarding the importance of quad stick, night light and supervision when mobilising

7.Provided information to patient and relative about risk factors, changes within the home and modifying medication To build aspects of care

A falls prevention intervention can then be offered

To re-educate patient in walking

9

To help patients adapt to their impairment

Prevents imposed dependence

To modulate tonal change and promote use of extensor muscle

These are proven falls prevention strategies

Knowing the risk factors may reduce the likelihood of fall

(Williams et al, 2010c)

(Williams et al, 2010d)

(SIGN, 2002)

(Willacey, 2008))

(Williams et al, 2010e)

(Williams et al, 2010f)

(Kerse et al, 2010)

(Esquenazi, 2008)

10
Health and Social Care Policies Influencing Patient’s Care
Mrs. G was brought to the hospital via ambulance when she suffered stroke because according to the National Stroke Strategy of the Department of Health (2007c), all patients with suspected acute stroke be immediately transported by ambulance to a hospital providing hyper-acute stroke services. She was likewise given prompt diagnosis and treatment as is mandated in the National Service Framework for Long-term Conditions (DoH, 2005). In addition, assessment of her level of consciousness, swallow test, risk for pressure sores, nutritional status, cognitive impairment, needs regarding moving and handling and referral to specialist rehabilitation team were undertaken and documented as stated in the National Clinical Guidelines for Stroke (RCP, 2000b).

Another key component from the National Stroke Strategy of the Department of Health (2007d) is the provision of a specialist coordinated rehabilitation team in the stroke unit. This team, which consists of physiotherapists and occupational therapists facilitated the enhancement in mobility, movement and activities of living of Mrs. G. A concise discharge care plan was made as well on the day of admission. It involved Mrs. G and her family in her overall care plan, including those occurring after hospitalization. Notification was also given to her general practitioner-doctor, primary healthcare teams and community social service and arrangements for all necessary equipment and support services post hospitalization were also carried out as per National Clinical Guidelines for Stroke (RCP, 2000c). A third key component from the National Stroke Strategy of the Department of Health (2007e) is health teaching on risk factors and lifestyle management issues. Mrs. G’s hypertension and high cholesterol level were managed according to clinical guidelines. She was also given a comprehensive advice on behavior and appropriate treatment to reduce risks for coronary heart disease as stated in the National Service Framework for Coronary Heart Disease of the Department of Health (2004).
As per hospital protocol, these tools were used in the medical management of this patient to assess and monitor for physiologic changes. Modified Early Warning Score (MEWS) system is a tool for bedside evaluation which focuses on five parameters: systolic blood pressure, pulse rate, respiratory rate, temperature and AVPU score. It is used to assess and identify medical patients at risk (Subbe et al, 2001). Since Mrs. G was a known hypertensive, MEWS was used to monitor her blood pressure. With the help of medication and lifestyle change, her blood pressure was maintained within normal range. The Waterlow Pressure Ulcer Risk Assessment identifies patients at risk for developing pressure ulcers and recognizes risk factors (RCN, 2001). Due to her hemiparesis, Mrs. G was regularly evaluated for the development of pressure sites on the weak side. This tool which incorporates the Malnutrition Universal Screening Tool (MUST) was used to monitor for changes in her skin integrity. In Mrs. G’s case, her Waterlow-MUST score was low risk since she was mobile, continent and had an average body mass index.

Another tool used was the Inpatient Faller Identification Tool which assesses and classifies patients as being high or low risk for falling (Sherrington et al, 2010). Mrs. G was admitted with a fall and was unsteady on her feet during assessment, hence a high risk score for this tool.

CRITIQUE AND EVALUATION
The Roper-Logan-Tierney model of nursing, which is based on activities of living (ALs) assesses an individual’s relative independence and potential for independence in ALs. As mentioned in the assessment, some of Mrs. G’s activities of living were hampered by her disability from stroke, hence the appropriateness of this model for assessment. This nursing model provided a solid foundation for the care plan of this patient by concentrating on areas that were relevant to her state of condition. The proper use of this type of assessment gave a clear picture of Mrs. G’s well being as well as her needs at that time. This helped the nursing team give a priority-driven care involving skills from the multi-disciplinary team. For example, the problem brought about by impaired mobility had engaged the services of doctors, nurses, physiotherapists, occupational therapists and psychologist, all of whom contributed in rebuilding the confidence and independence of the patient. Coordination with social care services, GP and relatives was also done to ensure continuity of care, as well as to provide physical, emotional and financial support for the patient.
The Roper-Logan-Tierney model of nursing has been suitable in the recognition of the patient’s problem because the patient was appraised through each activity of living. After thorough assessment, it has been identified that priority care should be given on mobility issue as this is associated with patient safety. For instance, the simple routine of toileting needs mobilization. In this case, Mrs. G’s capability to mobilize alone or with assistance; with or without the use of walking aids were evaluated and given appropriate interventions. Assessment also showed that she needed assistance in cleaning and dressing. The extent of this liability was likewise evaluated and given emphasis, so as to avoid occurrence of injuries or falls during bath. This type of assessment was also valuable, in the sense that staff allocation was thought off ahead of time depending on the need of the patient that was being prioritized at that time.
The nursing care plan addressed the need for patient safety to prevent patient falls. It dealt on patient empowerment and health education, as well as safety measures in mobilising. Strength training, for example has been given emphasis to speed up recovery, rehabilitation, and thus prevent future falls. One significant thing about this care plan was that it involved not only the patient, but the relative as well, in reducing identified risks for falls. Majority of the patient’s time are spent with relatives or carers / staff, so it is but wise to include them in the care plan as they are part of the care management team. The goals set in the care plan were to promote independence and to prevent in-hospital falls, as well as future falls. After implementation of said interventions and hard work from all the members of the multi-disciplinary team, Mrs. G was able to remain fall-free and independent on some of her activities of living.

CONCLUSION
Nursing rehabilitation is a crucial aspect of a stroke patient’s care and has to begin immediately after the stroke occurs to maximize benefit. By now, it is apparent that care for stroke patients should be individualized, meaning a person-centered rehabilitation program would ascertain that stroke patient’s needs are met in a way they find most beneficial for them. This type of program requires skilled multi-disciplinary team with strong links to social care, flexibility of care plan and most importantly, periods of intense rehabilitation.
Stroke in itself is a very sensitive issue for most survivors, regardless of gender or nationality. For many of these patients, life after stroke is just the beginning of the long journey of adjustment to and coping with its lingering effects. Recovery from stroke involves treatment, in which rehabilitation plays a big part. Majority of these stroke survivors perceive recovery as going back to pre-stroke activities, which is not always the case. As a result, this creates tension and havoc among patients, relatives and the multi-disciplinary team. One way to mend differences among all the people involved in the treatment is to incorporate communication, compassion and patience. These tools are vital in accomplishing the goals set by each person. On top of that, it is important that both the patient and relatives adapt to and accept the illness and its consequence, so as to become active members in the recovery process. Only when a patient starts to absorb information about his illness and its subsequent treatment, would recovery become truly meaningful.

The stroke rehabilitation unit in a hospital setting is a major breakthrough in healthcare. Patients who have had a stroke are given another chance to become active participants in their activities of living. They also benefit from the skills and knowledge of highly-qualified members of the multi-disciplinary team. However, for the common good of both patients and staff, it is imperative that the nurse-patient ratio be strictly 1:2, with one healthcare assistant per bay. This is relevant in terms of time spent and quality of care being given to each patient. If the quality of service rendered is high, chances are, recovery will be a lot faster, which would ultimately mean early discharge for the patient and less cash output for the hospital.

Rehabilitation is every nurse’s responsibility, and as rehabilitators, nurses are bound to act as teachers and travelling companion of patients in their rehabilitation journey. Though recovery depends largely on the patient, it is still the nurse’s role to motivate, inspire and guide these stroke survivors to achieve the goal of being able to function again in the community. A nurse’s contribution, in terms of patient outcome is worth more than a thousand words. It is when patients start to live their lives once again in the way they have aspired for, that nurses truly feel that their hard work has finally paid off.

References
Alexander, M., Faucett, J. et al (2000). The Patient in Need of Rehabilitation. Full-text [online]. Nursing Practice: Hospital and Home: The Adult. [Accessed 23 November 2010].
Bernhardt, J., Dewey, H. et al (2008). A Very Early Rehabilitation Trial for Stroke (AVERT). Full-text [online]. American Heart Association. [Accessed 23 November 2010].
Cheow, C. (2010). Sleep is An Important Aid to Stroke Recovery. Full-text [online]. Ezine Articles. [Accessed 23 November 2010].
Department of Health (2004). National Service Framework for Coronary Heart Disease: Winning the War on Heart Disease. 16-20. Full-text [online]. Department of Health. [Accessed 02 December 2010].
Department of Health (2005). National Service Framework for Long-term Conditions. p.4. Full-text [online]. Department of Health. Accessed 01 December 2010].
Department of Health (2007). National Stroke Strategy. London. Department of Health
Esquenazi, A. (2008). Falls and Fractures in Older Post-Stroke Patients with Spasticity: Consequences and Drug Treatment Considerations. Full-text [online]. Clinical Geriatrics. [Accessed 12 November 2010].
Healthtalkonline (2010). Stroke Recovery: Communication disorders. Full-text [online]. Healthtalkonline.Org. [Accessed 23 November 2010].
Healthtree (2010). Stroke Rehabilitation: Home Management and Nursing Facility. Full-text [online]. Healthtree. [Accessed 23 November 2010].
Kerse, N., Parag, V., Feigin, V. et al (2010). Preventing Falls Important for Stroke Patients. Full-text [online]. Americam Heart Association. [Accessed 12 November 2010].
National Health Service - Greater Glasgow and Clyde (NHS-GGC) (2010). Rehabilitation After A Stroke: Getting Back to Work. Full-text [online]. National Health Service – Greater Glasgow and Clyde. [Accessed 23 November 2010].
National Institute on Clinical Excellence (2008). Stroke: Diagnosis and Initial Management of Acute Stroke and Transient Ischaemic Attack. Clinical guideline 68, 17-19. Full-text [online]. National Institute on Clinical Excellence. [Accessed 22 November 2010).
National Stroke Association (2009). Stroke Facts. Full-text [online]. National Stroke Association. [Accessed 23 November 2010].
Rhodes, M. (2009). Stroke Recovery: Coping With Eating Problems. Full-text [online]. WebMD. [Accessed 23 November 2010].
Roper, N., Logan, W. et al (2000). Model of Nursing: Based on Activities of Living. Churchill: Livingstone.
Royal College of Nursing (2001). Pressure Ulcer Risk Assessment and Prevention. p. 14. Full-text [online]. Royal College of Nursing. [Accessed 01 December 2010].
Royal College of Physicians (2000). National Clinical Guidelines for Stroke. Sudbury, Suffolk: The Lavenham Press Ltd.
Scottish Intercollegiate Guidelines Network (2002). Management of Patients with Stroke. Volume 1, p.13. Full-text [online]. Scottish Intercollegiate Guidelines Network. [Accessed 12 November 2010].
Sherrington, C., Lord, S. et al (2010). Development of a Tool For Prediction of Falls in Rehabilitation Settings (Predict First).: A Prospective Cohort Study. Full-text [online]. JRM Medical Journals. [Accessed 05 December 2010].
Stroke Foundation (2008). What is Stroke? Full-text [online]. Stroke Foundation. [Accessed 23 November 2010].
Stroke Recovery Association (2009). The Effects of Stroke. Full-text [ online]. Stroke Recovery Association of Barrie and District. [Accessed 23 November 2010].
Stroke Rehab Online (SRO) (2010). Hope in Stroke Recovery Prayer Wishes. Full-text [online]. Stroke Rehab Online. [Accessed 23 November 2010].
Subbe, C.P., Kruger, M. et al (2001). Validation of a Modified Early Warning Score in Medical Admissions. Vol. 94, Issue 10. Full-text [online]. QJMed. Oxford Journals. [Accessed 05 December 2010].
Timby, B.K., Smith, N.E. (2003). Introductory Medical-Surgical Nursing. Philadelphia: Lippincott, Williams and Williams.
Vega, J. (2008). Sexuality After Stroke. Full-text [online]. About. Com. [Accessed 23 November 2010].
Willacey, H. (2008). Cerebrovascular Event Rehabilitation. Document Version 21. Full-text [online]. Patient UK. [Accessed 24 November 2010].
Williams, J., Perry, L. et al (2010). Acute Stroke Nursing. London: Blackwell Publishing Ltd.

Similar Documents

Premium Essay

Stroke

...Stroke Definition: A stroke is the sudden death of the cells in a specific area of the brain caused by inadequate blood flow. Another name for it is cerebral vascular accident (CVA). A stroke is also called a brain attack. Description: A stroke occurs when an artery bursts or becomes closed when a blood clot lodges in it and blood flow is interrupted to that part of the brain. Blood circulating to that area of the brain served by the artery stops at the point of rupture, and the brain tissue in that area dies or is damaged. The effects of a stroke are determined by which portion of the brain is affected and how much damage occurs. A stroke can cause memory loss, speech impairment, reasoning ability, loss of vision, paralysis, coma, and death, depending on what region of the brain is affected. Strokes are considered to be medical emergencies that require immediate treatment. About one third of strokes can be followed by transient ischemic attacks (mini-strokes). These strokes temporarily interrupt blood flow to the brain and cause similar symptoms like sudden vision loss or temporary weakness in a limb. Quick treatment can improve the chances of survival and increase the degree of recovery. A person who may have suffered a stroke should be seen in a hospital emergency room immediately. To be most effective, blood clot prevention treatment should begin within three hours of a stroke. More than half a million people in the United States experience a new or recurrent......

Words: 950 - Pages: 4

Premium Essay

Strokes

...A stroke is a type of cardiovascular disease that affects the cerebral arteries, those blood vessels that carry blood to the brain. A stroke occurs when one of those blood vessels in the brain is obstructed or ruptures flooding the brain with blood. Depriving blood and oxygen to the brain results in those immediate cells death, causing the brain not to function properly. Once parts of the brain stop functioning, it can directly affect the areas of the body controlled (1). A stroke can be generally be defined in two types of categories. The first and most common type of stroke is called ischemic stroke. This occurs when a blood clot (cerebral thrombosis) blocks a blood vessel in the brain. Blood flow beyond the blood clot is then restricted, and the part of the brain that relies on that blood supply becomes oxygen deficient and can die (1). A blood clot can develop in a narrowed artery that supplies the brain or can travel directly from the heart (or somewhere in the body) to an artery that supplies the brain. Blood clots are usually the result of other issues in the body that affect the normal blood flow. Common problems that affect the normal blood flow include: hardening of the arteries, irregular heart rhythms, infection of the heart valves, congenital heart defects, blood clotting disorders, inflammation of the blood vessels, etc. (2) The less common but more deadly of the two strokes is called a hemorrhagic stroke. A hemorrhagic stroke occurs when an artery in the......

Words: 804 - Pages: 4

Free Essay

Stroke

...Stroke The Causes And Effects Health And Social Care Essay ukessays.com /essays/health-and-social-care/stroke-the-causes-and-effects-health-and-socialcare-essay.php In this assignment I discuss Paul who is a 65 year old male and has suffered a stroke. My aim is to explain what a stroke is, the causes and effects, and give you my understanding of how I as a Health Care Worker can help identify, meet and care for the client's needs following a stroke. For this assignment I will bring together the knowledge I have gained as a health care assistant student to date along with some research also. I have carried out my research using the internet, Irish heart foundation, stroke centre organisation, stroke.ie. My focus as a health care assistant is to explain what care my client should receive after his stroke, identify the assistance needed and give recommendations to meet his rehabilitation, to help him keep abilities and gain back lost abilities and also take care of his needs such as physical, emotional, social and intellectual needs. Introduction "A stroke is caused by an interruption of the blood supply to part of the brain, the term stroke comes from the fact that it usually happens without any warning, 'striking the person from out of the blue" (ihf.com) A stroke can happen to anyone, some people are at higher risk for different reasons such as age and family history. Other risk factors include high blood pressure, smoking, being overweight, diabetes, and high cholesterol.......

Words: 1533 - Pages: 7

Premium Essay

Stroke

...One Stroke at a Time The brain is arguably the most complex of all the organs in your body. These three pounds of tissue compose the major nerve center of the body, which coordinates all of our bodily functions, including behavior, thought, and emotions. Because our brain is a very diligent working organ, it requires constant supplies and nutrients from the blood to function effectively. The heart pumps blood throughout the cerebral arteries delivering blood to the brain. Any significant interruption to the supply of nutrients and oxygen will start killing brain cells. Damage to the brain cells occur almost immediately upon abruption or even the slightest restriction of blood flow to the brain. Minor damage to any part of the brain can have a serious adverse effect on the rest of the body. Significant damage to the brain can even result in death. One relatively common cause of brain damage and death is referred to as a stroke. A stroke is similar to a heart attack, only in this case, blood flow to the brain rather than the heart, is blocked. A stroke or "brain attack" is usually the result of progressive disease that develops over many years. When blood flow fails, brain cells are robbed of vital supplies of oxygen and nutrients. Some strokes have little recognizable effect. While not usually fatal, a blockage of a blood vessel in the brain or neck is the most frequent cause of a stroke. It can leave a portion of dead tissue in the brain, called a cerebral infarction,...

Words: 2327 - Pages: 10

Premium Essay

Strokes

...A. Strokes have always been a prevalent illness in my family history. Unfortunately that’s not good news seeing as many of the risk factors associated with strokes are also prevalent in my family. The biggest two would be how prone my family is to high cholesterol and high blood pressure. Some other risk factors associated with strokes include: physical inactivity, cigarette smoking, heavy or binge drinking, use of illicit drugs, diabetes, and being overweight. What’s interesting about these risk factors is that both my parents do not smoke, are physically active seeing as they tend a small orchard grafting and budding trees, do not drink, definitely not overweight, and eat a healthy diet given both are vegetarians that frequently visit a local nutritionist. Perhaps I’ll come by during office hours to discuss it with you if you have time. B. Early signs or symptoms of strokes can be easily remembered with this mnemonic : FAST. • FACE: Keep an eye out for crooked smiles. The key here being that one side of a person’s face is drooping therefore clearly identifying nonresponsive facial muscles as a result of lowered brain activity relative to where those muscles are located. • ARMS: See if a person can hold their arms straight out without it falling. If an arm immediately starts drooping it’s indicative of a person stroking out sooner than you can imagine. • SPEECH: Have the person say a simple phrase and see if you notice their speech slurred. • TIME: If any one......

Words: 456 - Pages: 2

Free Essay

Strokes

...to dealing with stroke survivors the focus is always on the patient, how she will live, and the quality of her life. While dealing with these situations is the appropriate response it is also important to take into consideration that the patient is not the only one who had been affected by a stroke. This leads families and medical professionals alike by asking the question, how does a stroke impact the lives of the immediate family members of the stroke survivor? The aim of this study will be to determine the answer to this question by connecting how the changes in the quality of life for the survivor impact the lives of the immediate family. Developed Research Methodology As the main care giver of a spouse who has survived multiple strokes, it means that I am known by other immediate family members of stroke survivors as one of them and consequently I am aware of what they are experiencing. Acting as a participant observer is the most logical methodology to use for answering this question. The rationale behind this is that in the referred to situation I am known as a member of the group that is being studied rather than as a researcher, which is definition of a participant observer (Dorsten & Hotchkiss, 2014). The main technique of direct data collection that I intend to use is conducting interviews. Interviewing the immediate family members of a stroke survivor will allow me to determine how the changes that occurred as a direct result of the stroke have......

Words: 1257 - Pages: 6

Free Essay

Stroke

...with acute ischemic stroke. Methods—A survey was undertaken of 280 neurologists from the United States and 270 neurologists from Canada. Brief vignettes were presented for the following 5 scenarios: stroke in evolution, atrial fibrillation-related stroke (A FIB), vertebrobasilar stroke, carotid territory stroke, and multiple transient ischemic attacks. The effect of medicolegal factors was also ascertained. Statistical comparisons were done with chi-squared testing. Results—US neurologists were significantly more likely than Canadian neurologists to use intravenous heparin for patients with stroke in evolution (51% versus 33%, P0.001), vertebrobasilar stroke (30% versus 8%, P0.001), carotid territory stroke (31% versus 4%, P0.001), and multiple transient ischemic attacks (47% versus 9%, P0.001). The vast majority of US and Canadian neurologists would use intravenous heparin for acute stroke patients with A FIB (88% and 84%, respectively). US neurologists more often cited medicolegal factors as a potential influence on the decision-making process than Canadian neurologists (33% versus 10%, P0.001). Conclusions—In several clinical scenarios, US neurologists were significantly more likely than Canadian neurologists to use intravenous heparin. Fears regarding medicolegal consequences may partially explain the treatment disparity. Despite the publication of 4 clinical trials, which have not shown any long-term benefit for patients with acute stroke and A FIB......

Words: 1740 - Pages: 7

Premium Essay

Stroke

...There are three types of strokes that cause changes to the brain: Hemorrhagic stroke,Intracerebral hemorrhage and Transient ischemic attack (TIA). Ischemic stroke is the most common form of stroke, accounting for around 87% of strokes. Strokes are the 5th leading cause of death in the US, with one person dying every 4 minutes as a result. For African Americans, stoke is the 3rd leading cause of death.(http://www.cdc.gov/stroke/facts.htm) It is estimated that About 795,000 people have a stroke each year; about one every 40 seconds - there are many medical conditions that can cause a stroke and it is estimated that 8 out of 10 strokes can be prevented. However, there are some things that cannot be controlled when you are predisposed to stroke; such as your age and race.(http://www.webmd.com/stroke/stroke-causes-risks) A stroke is caused by an interruption of the blood supply to part of the brain, a stroke can happen to anyone - although there are different reasons that put some people at higher risks such as age, family history, high blood pressure, smoking, being overweight, diabetes and high cholesteral.(http://www.stroke.org/understand-stroke/what-stroke) The three types of strokes have specific causes. Ischemic stroke is the most common form of stroke, accounting for around 87% of strokes. This type of stroke is caused by blockages or narrowing of the arteries that provide blood to the brain, resulting in severely reduced blood flow. Hemorrhagic stroke are caused by......

Words: 963 - Pages: 4

Premium Essay

Stroke

...Strokes I. August 29th 2009. I will never forget that day. It was a life changing day for me, my family, and most of all, my grandma. II. My grandma experienced a massive stroke on that day. A. My grandma was helping her neighbor move into their new house and over worked herself. She became very tired and decided to rest. She then lost all feeling in her left side and my grandpa called 911 right away. B. This time was very life changing for me and my family. III Today I am going to inform you on the different types of strokes, the effects that a stroke can have on a person, and the signs of a stroke and how you can prevent it from happening. Body I. The two types of strokes that I will be talking about today are Hemorrhagic stroke and Ischemic stroke. A. A Hemorrhagic stroke is the rarer of the two types of strokes and accounts for about 13 percent of stroke cases which is what my grandma experienced. 1. It results from a weakened vessel that ruptures and bleeds into the surrounding brain. The blood accumulates and compresses the surrounding brain tissue. 2. The two types of hemorrhagic strokes are intracerebral hemorrhage or subarachnoid hemorrhage. B. Hemorrhagic stroke occurs when a weakened blood vessel ruptures. Two types of weakened blood vessels that usually cause hemorrhagic stroke are aneurysms and arteriovenous malformations or AVMs. 1. An aneurysm is a ballooning of a weakened region of a blood vessel. If......

Words: 1056 - Pages: 5

Free Essay

Strokes

...Stroke, Why People Have Them and How Do They Recover A stroke is one of those things that is not really predictable and doesn’t really care who is affected by it. I can honestly say that I didn’t ever really care to look into and study what a stroke was, or how people might recover from it until I met my wife. In what I know a stroke is a lack of oxygen to the brain for a period of time which will vary from person to person. During this time period where there is no oxygen flowing to the brain damage is being done. That damage will not fully present itself until the victim comes to and can attempt the regular day to day tasks and actions. People can have different side effects to strokes and different recovery times. Also, due to the severity of some peoples’ stroke, some symptoms may never go away. I always assumed that strokes only happened to older people, possibly with high blood pressure or a poor way of living. I never knew that this horrible thing could take victims that were so young and full of life. For my wife, her stroke came following a surgical procedure and she ended up in a coma. In her situation upon waking up it was discovered that she had lost all use of the left side of her body. As time went on it was also determined that her memory had been affected. At that point in time we didn’t really know what her recovery would entail and what if any improvements she would make. I just knew that we had to pray for the best and hope that......

Words: 1211 - Pages: 5

Premium Essay

Stroke

...Aggrenox Drug Platelet inhibitor and aspirin drug (oral) Angiography angi/o- (blood vessel; lymphatic vessel) (AN-jee-AW-grah-fee) -graphy (process of recording) Angioplasty angi/o- (blood vessel; lymphatic vessel) (AN-jee-oh-PLAS-tee) -plasty (process of reshaping by surgery) Anticoagulant anti- (against) coagul/o- (clotting) -ant (pertaining to) Arteriography arteri/o- (artery) (ar-TEER-ee-AW-graph-fee) -graphy (process of recording) Atherosclerosis ather/o- (soft, fatty substance) (ATH-eh-roh-skleh-ROH-sis) scler/o- (hard) -osis (condition; abnormal condition; process) Bruit (harsh, rush sound made by blood passing thru (BROO-ee) a narrowed artery) Cardiovascular cardi/o- (heart) (KAR-dee-oh-VAS-kyoo-lar) vascul/o- (blood vessel) -ar (pertaining to) Carotid Arteries carot/o- (stupor; sleep) (KAR-RAW-tid) -id (resembling; source of origin) Note: Bring oxygenated blood to the neck; face; head and brain Diabetes diabet/o- (diabetes) Echocardiography ech/o- (echo; sound wave) (EK-oh-KAR-dee-AW-grah-fee) cardi/o- (heart) -graphy (process of recording) Endarterectomy endo- (innermost; within) (END-ar-ter-EK-toh-mee) arter/o- (artery) -ectomy (surgical removal) Folate a salt; compound of folic acid (fo-lat) Heparin Potent anticoagulant oral drug (hep- -rin) Homocysteine Test as part of cardiac risk......

Words: 416 - Pages: 2

Free Essay

Stroke Rehabilitation

...Narrative Report - Left sided hemiparesis due to an ischemic stroke by Clifford Choi on Saturday, December 3, 2011 at 12:47am · I thank my mentors in neurology, integrative medicine, and my patient for his determination to overcome this. He is an atheist but believed in me and himself. The patient reports full recovery. Here is his letter 4 months later.  He has given permission to publish the report. He is back to work, travelling, driving, and has no known deficits. 80% of ischemic strokes survive the stroke, but it is uncertain how many fully recover 100% function. _________________________________________________  Dear Dr. Clifford Choi,  I tried to call the number you once gave me, but they told at the hospital SEIMC that you were not working there anymore. Anyway I just wanted to touch base and say hello to you and thank you and the colleagues you had at the hospital. The recovery has been very amazing. I was last week at this intensive rehabilitation (or so it was called) session at the _________  University hospital. I was supposed to be there the whole week, but they said that I’m actually in too good shape to gain anything from this anymore, so I left Wednesday morning. I’m allowed to drive now, and officially I will be back to work on August 26th. I can call you, if you want. But then I would need your phone number. The world is a small place, so maybe we some day run into each other. You never know. Best regards, patient x The report below was......

Words: 1796 - Pages: 8

Premium Essay

Post Stroke

...treating it then it increases the chances of having a stroke. Having a high blood pressure is the biggest reason and factor which causes stokes. The 50 percent of strokes that occur are due to some blockage called the ischemic stroke. It also increases the chances of bleeding occurring in the brain which is called the hemorrhagic stroke (Willmot, Leonardi-Bee, & Bath, 2004). Having a high blood pressure puts a lot of pressure and strain on the blood vessels throughout the body which includes the ones which lead to the brain. Due to which, the heart has to work hard in order to make sure that the blood circulation keeps on going. This strain that occurs damages the blood vessels which make them harder and narrower. This condition is called atherosclerosis. This makes it more likely that the blockage will occur which causes a stroke or transient ischaemic attack which is also called the mini stroke (Chobanian et al., 2003). On some very rare instances, the extra strain causes the blood vessels to get weak and burst inside the brain which causes bleeding into the surrounding tissues. This is called as a hemorrhagic stroke. The common symptoms of having a stroke include severe headache, confusion, losing coordination, losing vision, feeling numb or weak. The symptoms depend on the amount of damage which has been done to the brain. A stroke often leads to physical disability. It is possible for people who have had strokes in their life to recover the abilities that they lost......

Words: 2920 - Pages: 12

Premium Essay

Stroke Prevention

...Stroke Prevention Christina Thompson Grand Canyon Stroke Prevention What is a stroke? For my teaching plan I chose cognitive learning and so I created a poster-board and discussion on stroke explaining what a stroke is and signs and symptoms of one. The teaching itself consisted spending a lot of time at my community health department, specifically with the community health nurse, getting to know what their role is and how they accomplish much of what they do. She helped me set aside some time and a place to present the information. We did find it a little difficult with the demands of the assignment and their time because they had other obligations but were helpful and made time for me. They gave me suggestions and ideas and talked to me about the best approach for teaching my community would be receptive to. A poster board was discussed and decided upon after discussing the other options. They explained that most people in this learning group would not sit through a powerpoint and enjoy talking and telling their stories so with a poster-board they can browse and talk and pick up little take-aways. The nurse did explain that my local hospital that most of our community uses does not offer any free services and most of the services come from an adjacent hospital who provide them with a lot of free services and resources. So to be aware they will not appreciate where I am coming from but will appreciate that I am trying to learn. I also consulted with a teacher......

Words: 1553 - Pages: 7

Free Essay

Hemorrhagic Stroke

...Case Study James Morasco College of Southern Nevada – Nursing 211 Clinical Professor Judith Alewel, MSN, RN October 15, 2012 Introduction AV is a 57 year old male whom presented to the Emergency Department of Valley Hospital Medical Center in Las Vegas, NV on September 7, 2012 with the classic signs and symptoms of a left-sided middle cerebral artery (MCA) infarct and was admitted to the medical intensive care unit (MICU). These signs included left sided facial drooping, non-reactive left pupil, right sided weakness in the upper and lower extremities, and the inability to speak. Along with the signs and symptoms of the stroke, a 12-lead EKG revealed that he also has atrial fibrillation. The initial computerized tomography (CT) scan of his brain revealed nothing, but a subsequent MRA (magnetic resonance angiogram) concluded that he did, in fact, have an occluded branch of the left MCA that eventually converted to become hemorrhagic and he was admitted to the MICU. The MRA also found a persistent left trigeminal artery, which is insignificant to his presenting disease process. Along with all of this, a two dimensional echocardiogram revealed some significant hearts problems that will be discussed later. I cared for this patient during the clinical shift on September 18, 2012. History and Physical The only history and physical that was available in this patient’s chart was some narrative comments from his daughter notated by the physician, and this is most likely due......

Words: 4902 - Pages: 20