Stroke
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Cerebral Vascular Accident (Stroke)
Risk Factors
| Modifiable | Non-Modifiable |
|---|---|
| Hypertension Hyperlipidemia Diabetes Obesity Stress Oral Contraceptives Anticoagulants such as aspirin and warfarin | Genetics Age Gender (Male) Ethnicity such as black/hispanic |
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- With facial drooping or paralysis, the forehead is often spared. That is, the forehead is not paralyzed since the forehead receives input from central brain hemisphere.
- TIAs or transient ischemic attacks revolves within 24 hours, usually within 30 minutes.
- The affected arm is usually very weak and may be flaccid. Shoulder subluxation (dislocation) can occur. Arm should be in a sling.
Ischemic vs Hemorrhagic Stroke
| Ischemic | Hemorrhagic | |
|---|---|---|
| What? | Thrombosis= clot that formed in the wall of an artery in the brain. Embolic: A clot that traveled to the brain such as in atrial fibrillation Blood flow is cut off due to ischemia  | Ruptured Artery Aneurysm that ruptured Uncontrolled hypertension The collection of blood in the brain can cause increased intracranial pressure. The treatment for a hemorrhagic stroke is to stop the bleeding and prevent ↑ ICP.  |
Nursing Interventions
List of priorities in order
- Assess ABC: always priorities
- Stat CT scan: Take them to CT stat for diagnosis. Time is neurological function.
- Give thrombolytics such as alteplase
- Give antihypertensives such as atenolol. If BP no controlled the thrombolytics may cause hemorrhage.
