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BRAIN ATTACK - STROKE

By: Karen Peper RN MSN CFNP
Providence Hospital 9/07
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Objectives
Define Stroke

List types of Strokes

List risk factors for Stroke

Identify the signs and symptoms of
Stroke
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Stroke Statistics
Stroke is the No. 3 cause of death in the
U.S.
(#1 Heart Disease, #2 Cancer)

Stroke kills more than 160,000
American each year

On average, every 53 seconds, someone
in the US experiences a stroke.

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Stroke Statistics
Every 3.1 minutes someone dies of a
stroke

Stroke risk increases with age. For each
decade after age 55, the risk of stroke
doubles.

72% of all strokes occur in people over
the age of 65
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What is a Stroke?
Brain tissue is damaged from a sudden
loss of blood flow, resulting in a loss of
neurological function
Causes:
Blockage (blood clot) occurring inside a
blood vessel
Blood vessel leaks blood due to rupture
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Types of Strokes
Ischemic Stroke
(85%)


Hemorrhagic Stroke
(15%)
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Ischemic Stroke
Types of Ischemic Stroke

Embolic Stroke
Blood clot travels to the brain

Thrombotic Stroke
Blood flow is blocked to the
brain
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Hemorrhagic Stroke
Bleeding occurs from vessels
within the brain. High blood
pressure or a rupture of a
blood vessel or an aneurysm
may be the cause.





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Transient Ischemic Attacks (TIAs)
A stroke-like event lasting minutes, or hours,
that occurs when the brain is deprived of
oxygen-rich blood temporarily, but in which
the effects wear off completely after the blood-
flow returns

TIAs do not result in permanent brain damage

TIA is serious and too often ignored
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PLEASE
Pay Attention to these symptoms
TIAs should not be ignored
More that 1/3 of people will go on to have
an actual stroke
5% of strokes will occur within 1 month of
the TIA or first stroke
12% will occur within 1 year
20% will occur within 2 years
25% will occur within 3 years
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Stroke affects people of

All Ages

All Ethnic Groups

All Backgrounds

Most strokes are preventable, take steps NOW
to reduce having a stroke!
Stroke does not Discriminate
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Signs & Symptoms of Stroke
Sudden numbness or weakness of the face, arm,
or leg, especially on one side of the body

Sudden confusion, trouble speaking or
understanding

Sudden trouble seeing in one or both eyes

Sudden trouble walking, dizziness, loss of balance
or coordination

Sudden, severe headache with no known cause
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Strokes occur
in the brain and
affect the
opposite side
of the body
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Everyone
Please stand up

If you answer yes to any of the following
questions, please sit down

Thank you

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Risk Factors for Stroke
Blood Pressure over 120/80?
Smoker exposed to tobacco?
Overweight?
Diabetes?
High Cholesterol?
Heart Disease?
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Risk Factors for Stroke
Family History of Stroke?
Physical activityless than a total of 30
minutes on most days?
Man over age of 45, OR a woman over 55
years of age?

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Are you sitting down?
Yes, you are at risk for a stroke, but it
doesnt mean you will have one

There are risk factors that can be
controlled and risk factors that cannot be
controlled

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Risk Factors
Risk factors you can control:
DIET - How we eat, do we follow our diet?
EXERCISE - Do we exercise or get some
physical activity?
MEDICATIONS - Taking medications
correctly
SMOKING - Stop smoking


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Strokes can affect different parts of the brain,
this results in patients experiencing different
symptoms
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Strokes are an EMERGENCY
If you are having a Stroke come to the
hospital right away CALL 9-1-1
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Once You are at the Hospital
Diagnostic Testing

CT or MRI of the brain

EKG

Carotid Ultrasound

Echocardiogram

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EKG may show atrial fibrillation
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Carotid Ultrasound will show if there is
stenosis (narrowing of the blood vessel)
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Echocardiogram detects if any thrombus
(blood clot) within the heart chambers
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Chest X-ray
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Blood work - Labs
Any labs may be ordered, Lipid
Profile (checking your
cholesterol level) is done on all
patients.





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Recognize the Symptoms of a Stroke
3 Simple Questions

Ask the person to
smile

Ask the person to
raise both arms

Ask the person to say
a simple sentence
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ACT IN TIME
Stroke is a medical emergency. Every
minute counts when someone is
having a stroke. The longer blood flow
is cut off to the brain, the greater the
damage. Immediate treatment can
save people's lives and enhance their
chances for successful recovery
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tPA (Tissue Plasminogen Activator)

is a clot-busting drug

Ischemic strokes, the most
common type of strokes, can
be treated with a drug called t-
PA, that dissolves blood clots
obstructing blood flow to the
brain.


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TIME IS BRAIN
Time is very important in order to receive
this medication

Window of opportunity to start treating
stroke patients is three hours, but to be
evaluated and receive treatment, patients
need to get to the hospital within 60
minutes.

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Medications
Aspirin
Aggrenox
Plavix
Blood pressure medication
if appropriate
Cholesterol lowering
medicines if needed




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Hospital Treatment for Stroke
Medical Management
Dietary
Physical & Occupational Therapy
Speech Therapy if indicated
Nursing
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Hospital Treatment for Stroke
Rehabilitation
Physical Medicine Consult
Determine what type of
therapy best for patient
Rehab Unit
Subacute Rehab
Extended Care Facility
Home Care with PT/OT
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Discharge Planning
Starts upon admission to the hospital
Consult social worker or care coordinator to
help identify discharge needs

Provide patient/family with Stroke
education

Stroke Support Group meetings
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Can you SPOT a Stroke?
This is the end of the program


Do you have any questions??



THANK YOU.