Chapter 67 - Compare the various types of cerebrovascular

Adult Health 2

Brunner and Suddarth Chapter 67 

Reading: 

· Entire chapters

Charts/Tables/Figures

· Table 67-1, Comparison of Major Types of Strokes

· Figure 67-1, Patho of ischemic stroke

· Table 67-2, Neuro deficits of stroke

· Table 67-3, Comparison of L and R side stroke 

· Chart 67-2, Modifiable Risk Factors for Ischemic stroke

· Chart 67-3, Criteria for tPA

· Table 67-4, NIHSS 

· Figure 67-2, Carotid Endarectomy

· Chart 67-4, Assist devices

· Chart 67-5, Communication with the Patient with Aphasia

· Chart 67-6, Home care for stroke patient

Learning Objective #1: Compare the various types of cerebrovascular accidents (strokes), their causes, clinical manifestations, medical and nursing management.

a. Define stroke. Explain the use and reason for the term brain attack in describing stroke to the public. List the major types of stroke.

b. Describe ischemic stroke. List the types of ischemic strokes.

c. Describe the cascade of events and processes contributing to brain injury in ischemic stroke.

d. Describe the potential clinical manifestations of ischemic stroke, recognizing the location and size of the affected area and available collateral circulation. Use and define the medical terms associated with the manifestations. 

e. Describe transient ischemic attack (TIA) and its manifestations and causes. Why is it important to evaluate and treat TIA?

f. Describe the carotid endarterectomy. What are the indications for the procedure and what does it help prevent? 

g. Discuss preventive measures and secondary prevention of stroke for persons who have experienced TIAs or stroke. Discuss the medications in the detail.

h. Explain the medical management of stroke, emphasizing the need for prompt diagnosis and treatment, including diagnostic evaluation of stroke via imaging and standardized assessment tools.

i. What are the criteria for the administration of tissue plasminogen activator (t-PA) therapy? 

j. What ongoing assessments/monitoring while a patient is receiving t-PA? 

k. Describe t-PA action, administration, dosage, potential side effects. 

l. Describe other therapies used for the acute management of the patient experiencing a ischemic stroke.

m. Discuss the assessment of patients recovering from an ischemic stroke, including the acute phase and rehabilitation.

n. Describe hemorrhagic stroke, including its causes, pathophysiology, clinical manifestations.

o. What are the nursing interventions for hemorrhagic stroke?

p. Discuss the home care and patient and family education for a patient who has had a stroke. List and discuss the essential elements for developing a teaching plan.