Stroke (Cerebrovascular Accident) Overview

Introduction

• Cathy from LevelUpRN discusses strokes, also known as cerebrovascular accidents.
• Includes a quiz at the end to test understanding.
• Suggested using medical-surgical nursing flashcards to follow along.

Definition of Stroke

• Sudden interruption of blood flow to the brain.
• Deprives brain of oxygen and nutrients leading to tissue damage and necrosis.

Types of Strokes

• Hemorrhagic Stroke: Caused by a ruptured artery or aneurysm in the brain.
• Ischemic Stroke: Caused by a blood clot.
  • Thrombotic Stroke: Blood clot in the cerebral artery.
  • Embolic Stroke: Blood clot travels from another part of the body to the cerebral artery (e.g., from a DVT).

Risk Factors for Stroke

• Smoking
• Hypertension
• Diabetes
• Atrial Fibrillation (A-fib)
• Hyperlipidemia
• Previous Transient Ischemic Attack (TIA)

Symptoms of Stroke

• Unilateral limb weakness (e.g., arm or leg on one side)
• Facial drooping
• Slurred speech
• Dizziness
• Visual disturbances

Left-sided Stroke

• Causes expressive aphasia (difficulty speaking or understanding language).
• Affects reading and writing abilities.
• Key Point: Left brain equals language issues.
• Results in right-sided weakness or paralysis.

Right-sided Stroke

• Leads to poor judgment and impulse control.
• Causes the patient to overestimate abilities.
• Key Point: Right brain equals reckless behavior.
• Results in left-sided weakness or paralysis.

Diagnosis of Stroke

• CT scan
• MRI
• Cerebral angiogram

Treatment of Stroke

Ischemic Stroke

• Use of thrombolytic agents like Alteplase.
• Must administer thrombolytics within three hours of symptom onset.
• Other medications include anticoagulants and antiplatelets.

Hemorrhagic Stroke

• Administration of antihypertensive agents to reduce blood pressure and minimize blood loss.

Nursing Care

• Implement fall precautions due to potential paralysis.
• Assess swallowing ability and gag reflex before eating/drinking.
• Use thickened liquids if dysphagia is present.
• Advise chin-tucking during swallowing.
• Frequently reposition patients to prevent pressure injuries.
• Use scanning techniques for patients with homonymous hemianopsia (only seeing one side of the visual field).

Quiz

1. Question: A temporary blockage of blood flow to the brain is called a ___.
   • Answer: TIA (Transient Ischemic Attack)
2. Question: A stroke on the left side of the brain can cause expressive aphasia. True or false?
   • Answer: True
3. Question: For an ischemic stroke, thrombolytics should be administered within ___ hours of symptoms.
   • Answer: Three hours

Conclusion

• Reminder to like and leave a comment on the video if it was helpful.