Stroke

Question 1

Stroke risk factors

Answer 1

• Stroke risk increases with age, doubling each decade after 55 years of age. Two-thirds of all strokes occur in individuals >65 years.
• Strokes are more common in men, but more women die from stroke than men.
• A family history of stroke, a prior transient ischemic attack (TIA), or a prior stroke also increases the risk of stroke.
• Hypertension is the single most important modifiable risk factor, but it is still often undetected and inadequately treated.
• Heart disease, including atrial fibrillation, myocardial infarction, cardiomyopathy, cardiac valve abnormalities, and cardiac congenital defects, is a risk factor for stroke.
• Women who drink more than one alcoholic drink per day and men who drink more than two alcoholic drinks per day are at higher risk for hypertension, which increases their chance of stroke.

Question 2

Symptoms Intracerebral hemorrhage

Answer 2

Neurological deficits
Headache
Nausea and/or vomiting
Decreased levels of consciousness
Hypertension

Question 3

Stroke symptoms

Answer 3

Motor activity
Elimination
Intellectual function
Spatial–perceptual alterations
Personality
Affect
Sensation
Communications

Question 4

Spatial–perceptual problems may be divided into four categories.

Answer 4

1. Deny illness or own body parts (anosognosia)
2. Erroneous perception of self in space
3. Inability to recognize an object by sight, touch, or hearing (agnosia)
4. Inability to carry out learned sequential movements on command (apraxia)

Question 5

Stroke goals

Answer 5

preserving life.
preventing further brain damage.
reducing disability.

Question 6

Stroke Interventions

Answer 6

Ensure patent airway.
Call stroke code or stroke team.
Remove dentures.
Perform pulse oximetry.
Maintain adequate oxygenation.
Obtain IV access with normal saline.
Maintain BP according to guidelines. 
Remove clothing.
Insert Foley catheter
Obtain CT scan immediately. 
Perform baseline laboratory tests.
Position head midline.
Elevate head of bed 30 degrees if no symptoms of shock or injury occur. 
Institute seizure precautions.
Anticipate thrombolytic therapy for ischemic stroke. 
Keep client NPO until swallow reflex evaluated.

Question 7

Post stoke issues

Answer 7

• skin breakdown
• DVT
• need to maintain optional muskulo-skel function
• constipation
• poor bladder control
• may need IV for fluid/electolytes