Acute Care of the Client with a stroke

Acute care and nursing priorities

CT Scan

Must differentiate between a hemorrhagic stroke versus a non-hemorrhagic stroke.

Control Hypetension

Especially in hemorrhagic strokes.

rtPA

For Non-hemorrhagic only. Antifibrinolytic must be given within 3 to 4.5 hours of the first sign of stroke. Time first symptom developed is important.

Prevent seizures

Monitor for seizure activity

Cerebral Edema

Prevent with osmotic diuretics such as mannitol and corticosteroids such as solumedrol.

Protect Airway

Remember tongue may obstruct airway plus ALOC may lead to respiratory failure and pneumonia.

Prevent Aspiration

Aspiration due to ALOC and poor gag reflex. Side-lying with HOB elevated.

Let's look at a simple case study.

Which of the following

Accordion #2

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Neurological Disorders