Managing Medications Post-Stroke Flashcards
What are the 2 types of strokes?
Ischaemic
Haemorrhagic
What happens once someone has had a stroke?
They are then at further risk of another vascular event
How are strokes different?
Lasts more than 24hrs
How are transient ischaemic attacks (TIA) different?
Less than 24hrs
What are complications in early period?
Cerebral oedema = fluid on brain
Delirium
Seizures
VTE = pulmonary embolism
Cardiac complications
Infection
What are the long term complications?
Continence problems
Fatigue
Oral health
Cognitive dysfunction
Mood + wellbeing
Communication
Swallowing
What does the treatment of continence depend on?
Underlying cause of it
What may be the underlying cause of continence?
Times toileting
Prompted voiding
Bladder retaining
Pelvic floor exercises
Drug treatments
What is fatigue?
Tiredness or lack of energy
BUT following a stroke its not relieved by rest
How do you manage fatigue?
Assess person for mental + physical factors
Treat any reversible causes
Provide person + their family with info + support
How do you manage oral health?
Carry out mouth care at least 3 times a day
Especially for those who are tube fed
What is the dental gel called that you can give them?
Chlorhexidine
How do you manage cognitive dysfunction?
Consider screening all people with stroke or TIA for cognitive impairment
Then if necessary refer people to dysfunction assessment
How do you manage mood + wellbeing?
Discuss with stroke physician
Consider referring for behavioural therapy
Consider brief psychological interventions (eg. motivational interviewing)
Then antidepressants
Describe the use of antidepressants
Monitor for adverse effects
Treat for at least 4 months
If mood not improved after 2-4 weeks
Check adherence before considering dose increase or alternative
How to manage communications?
Offer support from speech + language therapy
How to manage swallowing?
Monitor dietary intake + nutritional stats
Refer to dietician if needed
Refer to stroke specialist if person unable to swallow
How many stroke patients does dysphagia affect?
More than 50%
Can dysphagia improve?
YES - within 2 weeks for most people
What are the complications for dysphagia?
Aspiration pneumonia
Choking
Compromised nutrition + dehydration
Reduced QoL
What are the options for overcoming swallowing issues?
Crushing + dispersing medications
Switching formulations
When it is a dispersible tablet does it have to be dispersed in H2O?
No it can be in juice
What must you do if it is switched to a liquid?
State the new dosage
If you crush it into H2O, what must you do?
State the amount of water to disperse it into
What must you do if you are crushing multiple medicines?
Each one should be prepared + provided separately
