Stroke

Stroke

1. Complications

2. Pathology

3. Treatment

4. Diagnostic Studies

   • Other: CSF analysis, Coagulation studies, CBC, Electrolytes, blood glucose, Hb A1C, Lipid profile, renal and hepatic studies
   • Diagnosis of Stroke: CT scan, CT angiography, MRA, MRI
   • Cardiac Assessment: Cardiac markers [Troponin, Creatine-kinase-MB, Chest radiograph, Echocardiography, Electrocardiogram]
   • Cerebral Blood Flow: carotid angiography, carotid duplex scanning, cerebral angiography, digital subtraction angiography, transcranial Doppler ultrasonography

5. Nursing Management

   • Nursing Diagnoses
     • risk for aspiration, impaired physical mobility, impaired verbal communication, unilateral neglect, impaired swallowing, impaired urinary eliminatio, situational low self-esteem, decreased intracranial adaptive capacity
   • Nursing Assessment
     • Primary Assesment:
       • Subjective Data: Past health history, medications, symptoms
       • Objective Data: General, respiratory, cardiovascular, Gastro-intestinal, Urinary, Neruological, Diagnostic Test
     • Secondary Assessment
       • Comprehensive Neurological Exam - Level of consciousness -cognition -motor abilities -cranial nerve function -sensation -proprioception -cerebellar function -deep tendon reflexes
   • Planning
     • Patient, Nurse & Family Establish Goals:
       • Maintain stable/improved LOC, attain maximum physical functioning, attain maximum self-care abilities and skills, maintain stable body functions, maximize communication abilities, maintain adequate nutrition, avoid complications of stroke, maintain effective personal and family coping skills
   • Implementation
     • Health Promotion & Acute Intervention & Ambulatory & Home Care

6. Clinical Manifestations

   • Motor Function
   • Communication: aphasia & dysarthria
   • Mood and Affect exaggerated or unpredictable emotional responses, frustration and/or depression
   • Spatial and Perceptual:
   • Elimination Urination & BM: Frequency, urgency, incontinence & constipation

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