NCLEX Review & Nursing School

STROKE

• CEREBROVASCULAR ACCIDENT (CVA) CAN BE A REDUCTION IN CEREBRAL BLOOD FLOW AND OXYGEN OR A BLEEDING OR HEMORRHAGING OF A BLOOD VESSEL.

TWO TYPES OF STROKE:

* ISCHEMIC Stroke

• occur as a result of an obstruction within a blood vessel supplying blood to the brain.

* Hemorrhagic Stroke

• occurs when a weakened blood vessel ruptures

When a patient has HEMIPARESIS (one side is paralyzed): Place the patient in the affected side in order to prevent airway obstruction and reduce the risk of aspiration.

HOMONYMOUS HEMIANOPSIA- loss of vision in half of the visual field can occur following a stroke.

DIAGNOSIS:

• DIAGNOSIS CAN BE DETERMINED BY A CT SCAN, CEREBRAL ARTERIOGRAPHY, ELECTROENCEPHALOGRAPHY, AND MRI.
• CAROTID ENDARTERECTOMY
• A SURGICAL INTERVENTION USED IN A STROKE MANAGEMENT AND CAN BE USED AS A STROKE PREVENTION.

Important Assessments:

• HEADACHE, NAUSEA, VOMITING
• FACIAL DROOPING
• APHASIA, SPEECH CHANGES
• NUCHAL RIGIDITY

Treatments:

Anticoagulants/Antiplatelets
Antiplatelet agents such as aspirin and anticoagulants such as warfarin interfere with the blood’s ability to clot and can play an important role in preventing stroke.

1. Warfarin (Coumadin)
2. Heparin

Carotid Endarterectomy 
Carotid endarterectomy is a procedure in which blood vessel blockage is surgically removed from the carotid artery.

Angioplasty/Stents
Doctors sometimes use balloon angioplasty and implantable steel screens called stents to treat cardiovascular disease and reduce fatty buildup clogging a vessel.