Stroke

Do you find it scary and overwhelming to take care of someone who has suffered a brain injury? Caring for a patient who has had a stroke can be very challenging. Trust us, we have been right where you are and we know the intimidation you might feel when thinking of all the components of caring for patients with this complex diagnosis. Nursing assessment is a crucial piece of the overall puzzle that will determine how the patient is cared for and, ultimately, the outcome of the patient. From the moment a patient arrives to the hospital with stroke-like symptoms, all members of the stroke care team begin working on the patient's history, obtaining tests, drawing labs, developing a plan, implementing safety measures, carrying out time-sensitive orders, and educating the patient and the patient's family. This book is a guide for anyone new to caring for stroke patients in the hospital setting. We have used our own nursing and teaching experience to help explain how to assess, anticipate, and prevent complications, and what to expect while caring for anyone who has been admitted to the hospital for a stroke or stroke-like symptoms. Our hope is that you feel more confident while caring for and educating this patient population. Table of Contents Chapter 1: Anatomy and Physiology

Parts of the Brain

Blood Supply

Risk Factors

Transient Ischemic Attack (TIA)

Ischemic Stroke

Hemorrhagic Stroke

Chapter 2: Assessment

Common Stroke Symptoms

Components of a Neurological Assessment

NIH Stroke Scale

Chapter 3: Orders

Emergency Department Orders

General Stroke Orders

Ischemic Stroke Orders

Hemorrhagic Stroke Orders

Chapter 4: Complications

Cerebral Edema and Herniation

Hemorrhagic Conversion

Seizures

Chapter 5: Nursing Care and Considerations

Time Is Brain

Impaired Communication

Swallow Precautions

Bowel and Bladder Issues

Mobility

Fall Prevention

Pain Management

Emotional Support

Discharge Planning

Chapter 6: Critical Care and Interventions

Ventriculostomy (Ventric) and External Ventricular Drains (EVD)

Intracranial Pressure Monitoring

Tissue Plasminogen Activator (tPA)

Intraarterial tPA

Craniotomy (Crani)

Aneurysm Clipping

Craniectomy

Neurovascular Interventions

Chapter 7: Case Studies

Case Study 1, 2, 3, 4