Materiały źródłowe

• #1 Stroke: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/5601-stroke

  A stroke is a medical emergency. Learn what to do if you or a loved one is having a stroke. […] A stroke is a medical emergency that happens when something prevents your brain from getting enough blood flow. A blocked blood vessel or bleeding in your brain can cause strokes. […] Strokes are the second leading cause of death worldwide and the fifth most common in the U.S. […] If you think you or someone youre with is having a stroke, immediately call 911 or your local emergency services number. Strokes are life-threatening and can be fatal. The sooner someone is diagnosed and treated, the more likely it is theyll survive a stroke. Every second counts. […] Stroke rehab is an important part of stroke treatment. Youll need rehab to help you adjust to changes in your brain and body after a stroke. You may need to regain abilities you had before or adjust to new or different disabilities. […] Maintaining your overall health is the best way to reduce your stroke risk. […] After a stroke, its essential to get treated right away. Cleveland Clinics stroke care specialists can help you manage recovery and improve your quality of life.

• #1

  https://journals.lww.com/nursingmanagement/fulltext/2016/02000/update__stroke_guidelines.1.aspx

  To provide information on the evaluation and treatment of stroke patients. […] After completing this continuing-education activity, you should be able to: Examine the etiology, risk factors, signs and symptoms, and assessment of patients with stroke. […] Evaluate treatment options for stroke patients. […] Within 25 minutes of arrival to the ED, the patient with symptoms of stroke should have a noncontrast CT scan of the brain. […] According to the AHA, diagnostic results from the brain scan should be available to the stroke team within a maximum of 30 minutes from time of arrival to the ED. […] If it’s indicated, fibrinolytic therapy for a stroke should begin within (at most) 60 minutes of arrival to the ED? […] According to the AHA, the gold standard for treating ischemic stroke is endovascular thrombectomy. […] In well-screened patients at low risk for bleeding, tPA can be administered up to 4.5 hours after arrival to the ED. […] To minimize complications for the stroke patient, the nurse should elevate the head of the bed to a minimum of 30 degrees.

• #1 Cerebrovascular Accident (Stroke) Nursing Care and Management: A Study Guide

  https://nurseslabs.com/cerebrovascular-accident-stroke/

  Learn about the nursing care management of patients with cerebrovascular accident in this nursing study guide. […] After the stroke is complete, management focuses on the prompt initiation of rehabilitation for any deficits. […] During the acute phase, a neurologic flow sheet is maintained to provide data about the following important measures of the patients clinical status: Change in level of consciousness or responsiveness. […] Based on the assessment data, the major nursing diagnoses for a patient with stroke may include the following: Impaired physical mobility related to hemiparesis, loss of balance and coordination, spasticity, and brain injury. […] The major nursing care planning goals for the patient and family may include: Improve mobility. […] Nursing care has a significant impact on the patients recovery.

• #1 14 Stroke (CVA) Nursing Diagnosis and Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cerebrovascular-accident-stroke-nursing-care-plans/

  Prevent straining at stool, holding breath, and physical exertion. […] Stress smoking cessation. […] Administer supplemental oxygen as indicated. […] Administer medications and insulin as indicated. […] Monitor laboratory studies as indicated: prothrombin time (PT), activated partial thromboplastin time (aPTT), and Dilantin level. […] Prepare for surgery, as appropriate. […] The goal of care for clients with limited physical mobility is to maintain and improve the clients functional abilities through maintaining normal functioning and alignment, reducing spasticity, preventing edema of extremities, and preventing complications of immobility. […] Assess the extent of impairment initially and functional ability. Classify according to a 0 to 4 scale. […] Monitor the lower extremities for symptoms of thrombophlebitis.

• #1 Acute Stroke (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568693/

  A cerebrovascular accident, more commonly known as a stroke, is broadly classified as either ischemic or hemorrhagic. […] With early, focused treatment based on the stroke etiology, rehabilitation programs, and long-term lifestyle changes, one can maximize their chances for a meaningful recovery. […] List the nursing needs of a patient with a stroke. […] Nursing Diagnosis: Inadequate cerebral perfusion, Impaired ability to communicate, Impairment in physical mobility, Altered sensory perception, Inability to perform daily living activities, Impaired swallowing, Ineffective coping. […] Assess mental status and level of consciousness. […] Observe for neurological deficits with frequent and serial neurological assessments. […] Provide deep vein thrombosis (DVT) prophylaxis. […] During the time-dependent early stroke phase and rehabilitation, stroke care involves an interprofessional team to prevent the disease.

• #1 Postdischarge nursing care of stroke patients

  https://www.myamericannurse.com/postdischarge-nursing-care-of-stroke-patients/

  Postdischarge nursing care of stroke patients […] Nursing care is essential to stroke management during hospitalization and, in many cases, after discharge well. […] Research shows comprehensive care during the first 4 weeks after a stroke improves overall morbidity and mortality. […] Throughout recovery, the patients needs change, so the care plan and treatment plan must be modified accordingly. […] Dysphagia (swallowing impairment) is a common result of stroke and puts patients at high risk for pneumonia. […] After an acute stroke, nearly two-thirds of patients develop at least one complication. Nursing care and medical management should be tailored to the individual patient, with a focus on preventing complications. […] To help prevent stroke recurrence, help patients identify and modify stroke risk factors.

• #1 14 Stroke (CVA) Nursing Diagnosis and Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cerebrovascular-accident-stroke-nursing-care-plans/

  Use the start low and go slow approach during exercise. […] Monitor the client for signs and symptoms of pulmonary embolism or cardiac overload during exercise. […] Set goals with the client and significant other (SO) for participation in activities and position changes. […] Incorporate fall prevention strategies. […] The incidence of aphasia (a language disorder that affects the ability to communicate) in acute stroke clients is about 30%. […] Differentiate aphasia from dysarthria. […] Assess the client for aphasia. […] Assess the client for dysarthria. […] Ask the client to follow simple commands (Close and open your eyes, Raise your hand); repeat simple words or sentences. […] Point to objects and ask the client to name them. […] Have the client produce simple sounds (dog, meow, Shh).

• #1 14 Stroke (CVA) Nursing Diagnosis and Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cerebrovascular-accident-stroke-nursing-care-plans/

  Consult and refer the client to a speech therapist. […] Arrange for participation in group, speech, and language therapy, as indicated. […] Provide information about other treatment options, such as melodic intonation. […] Post-stroke pain is common and can affect the rehabilitation and quality of life of stroke survivors. […] Assess the client for shoulder stiffness and pain. […] Assess the client for central poststroke pain (CPSP) syndrome. […] Assess for possible risk factors that contribute to the clients pain. […] Assess for the presence of post-stroke headaches. […] Recognize the need for a properly worn sling or orthoses. […] Assist the client when changing position. […] Position the shoulder of the client appropriately. […] When lifting the arm, it should be moved slowly and rotated outward.

• #1 Treatment and Intervention for Stroke | Stroke | CDC

  https://www.cdc.gov/stroke/treatment/index.html

  Rehabilitation after a stroke begins in the hospital, often within a day or 2 after the stroke. […] Recovery time after a stroke is different for everyone—it can take weeks, months, or even years. […] You and your health care team can discuss what to expect after a stroke. […] Your health care team will work with you to prevent further strokes. […] Rehab can include working with speech, physical, and occupational therapists. […] Therapy and medicine may help with depression or other mental health conditions following a stroke. […] Support from family and friends can also help relieve fear and anxiety following a stroke.

• #1 Nursing Interventions for Stroke Recovery | Wild Iris Medical

  https://wildirismedicaleducation.com/blog/nursing-interventions-stroke-recovery

  Effective nursing interventions for stroke recovery are crucial for optimizing patient outcomes. […] With timely medical intervention and comprehensive acute stroke nursing care, stroke survivors can make significant strides toward recovery and regaining independence. […] Providing acute care and conducting an initial assessment are key components of the intervention process. […] Physical rehabilitation plays a pivotal role in helping stroke survivors regain strength, coordination, and mobility. […] Facilitating speech and language recovery is crucial. […] By actively listening, offering encouragement, and providing education on coping mechanisms, nurses can help reduce anxiety, depression, and feelings of social isolation experienced by stroke survivors. […] By providing acute care, facilitating physical rehabilitation, enabling speech and language recovery, and addressing emotional well-being, nurses play a vital role in improving outcomes and promoting a sense of hope amidst adversity. […] Ongoing education and research in stroke nursing interventions are essential to further enhance the quality of care provided and support the long-term well-being of stroke survivors.

• #1 Stroke – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/stroke/diagnosis-treatment/drc-20350119

  Most people who have had a stroke go to a rehabilitation program. Your healthcare professional can recommend the therapy program that is right for you. […] Every person’s stroke recovery is different. Depending on your condition, your treatment team may include: Doctor trained in brain conditions, known as a neurologist, Rehabilitation doctor, known as a physiatrist, Rehabilitation nurse, Dietitian, Physical therapist, Occupational therapist, Recreational therapist, Speech pathologist, Social worker or case manager, Psychologist or psychiatrist, Chaplain. […] Speech therapy is often a part of stroke rehabilitation. […] Emergency treatment depends on whether you’re having an ischemic or hemorrhagic stroke. […] Emergency measures include treatment to counteract the blood thinners’ effects, medicines to lower the pressure in your brain, lower blood pressure, prevent spasms of the blood vessels and prevent seizures.

• #1 Cerebrovascular Accident (Stroke) Nursing Care and Management: A Study Guide

  https://nurseslabs.com/cerebrovascular-accident-stroke/

  Here are some nursing interventions for patients with stroke: Positioning. […] Consult with a speech therapist to evaluate gag reflexes and assist in teaching alternate swallowing techniques. […] Provide emotional support and encouragement to prevent fatigue and discouragement. […] Patient and family education is a fundamental component of rehabilitation. […] Nurses should assess caregivers for signs of depression, as depression is also common among caregivers of stroke survivors.

• #1 Acute Stroke (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568693/

  Nurses must coordinate care with these interprofessional team members to ensure functional assessments and speech/swallow assessments have been made for these patients with the implementation of recommended interventions. […] Educate the patient and caregiver on the following: Eating healthy, Do not lead a sedentary lifestyle, Observe compliance with medications, Follow up with a clinician, Do not smoke, Control blood pressure, blood glucose, and hyperlipidemia, Participate in regular exercise. […] Patients with a stroke can deteriorate rapidly. […] The nurse should monitor the patient closely for any new neurological deficit and inform the clinician. […] According to the American Heart Association and American Stroke Association, the following points are an essential part of the discharge discussion: Education regarding the causes of stroke, Education regarding modifiable risk factors for stroke, Education regarding blood pressure and glucose management, Education regarding healthy dietary intake, Education regarding the use of assistive devices, as advised by the therapy teams to prevent the risk of falls, Emphasizing medication compliance, Emphasizing follow-up compliance, Ensuring patients and caregivers understand the signs and symptoms of stroke to ensure timely evaluation in the event of a recurrent stroke.

• #1 14 Stroke (CVA) Nursing Diagnosis and Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cerebrovascular-accident-stroke-nursing-care-plans/

  Identify individual risk factors (e.g., hypertension, cardiac dysrhythmias, obesity, smoking, heavy alcohol use, atherosclerosis, poor control of diabetes, use of oral contraceptives) and discuss necessary lifestyle changes. […] Assess the clients and family members health literacy. […] Include significant others (SO) and the family in discussions and teaching. […] Discuss specific pathology and individual potentials. […] Review current restrictions and discuss the potential resumption of activities (including sexual relations). […] Reinforce the current therapeutic regimen, including using medications to control hypertension, hypercholesterolemia, and diabetes, as indicated; aspirin or similar-acting drugs, for example, ticlopidine, warfarin sodium. […] Provide written instructions and schedules for activity, medication, and essential facts.

• #1 Treatment and Intervention for Stroke | Stroke | CDC

  https://www.cdc.gov/stroke/treatment/index.html

  If you have had a stroke, you are at high risk for another stroke. […] Your stroke treatment begins the moment emergency medical services (EMS) arrive to take you to the hospital. […] Once at the hospital, you may receive emergency care, treatment to prevent another stroke, rehabilitation to treat the side effects of stroke, and/or all three. […] The key to stroke treatment and recovery is getting to the hospital quickly. […] Stroke patients who are taken to the hospital in an ambulance may get diagnosed and treated more quickly than people who do not arrive in an ambulance. […] Recognizing the signs and symptoms and seeking immediate medical attention (by calling 9-1-1) is essential to prevent stroke related disability or death. […] Your doctor may give you medications or tell you to change your diet, exercise, or adopt other healthy lifestyle habits.

• #1 14 Stroke (CVA) Nursing Diagnosis and Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cerebrovascular-accident-stroke-nursing-care-plans/

  Strengthen the healthcare staffs knowledge about stroke and post-stroke care. […] Thrombolytics: Tissue plasminogen activator (tPA), recombinant tPA (rt-PA) […] Anticoagulants: warfarin sodium, low-molecular-weight heparin […] Antiplatelet agents: aspirin, dipyridamole, ticlopidine […] Antifibrinolytics: aminocaproic acid […] Antihypertensives: ACE inhibitors, diuretics […] Peripheral vasodilators: nitroprusside sodium […] Neuroprotective agents: excitatory amino acid inhibitors and gangliosides. […] Anticonvulsants: phenytoin and phenobarbital; benzodiazepines: diazepam, lorazepam […] Stool softeners. […] Administer insulin therapy as indicated. […] Monitor laboratory studies as indicated: prothrombin time (PT), activated partial thromboplastin time (aPTT), and Dilantin level. […] Monitor computed tomography scan.

• #1 Stroke – Diagnosis and Treatment | Conditions, Treatments & Specialty | Geisinger

  https://www.geisinger.org/patient-care/conditions-treatments-specialty/stroke-care

  Comprehensive stroke care […] From immediate diagnostics to the most advanced treatment options, our stroke care teams partner with community emergency medicine providers to make sure you get the treatment you need as soon as possible. […] If you or a loved one ever need to see us for stroke care, you’ll work with a comprehensive, collaborative team including a group of physicians, occupational and physical therapists, speech-language pathologists, certified therapeutic recreation specialists, rehabilitation nurses and support staff. All of whom coordinate your care so you can get back to feeling better as quickly as possible. […] Stroke care resources you’ll have access to include: 24/7 stroke care at all our hospitals, a nationally recognized Acute Stroke Program, a nursing unit dedicated to treating stroke patients, comprehensive Stroke Center designation by the Joint Commission and the American Heart Association/American Stroke Association at Geisinger Medical Center and Geisinger Wyoming Valley Medical Center, primary Stroke Center designation by the Joint Commission and the American Heart Association/American Stroke Association at Geisinger Community Medical Center, Geisinger Jersey Shore Hospital and Geisinger Lewistown Hospital, telestroke care, a telemedicine-based remote stroke consultation that provides real-time, immediate stroke evaluation, inpatient and outpatient rehabilitation, research-proven care that helps stroke victims recover with fewer disabilities.

• #1 8. Acute Stroke Unit Care | Canadian Stroke Best Practices

  https://www.strokebestpractices.ca/recommendations/acute-stroke-management/acute-stroke-unit-care

  Patients admitted to hospital with an acute stroke or transient ischemic attack (TIA) should be treated on an inpatient stroke unit as soon as possible; ideally within 24 hours of hospital arrival. […] All efforts should be made to admit patients to an acute stroke unit, which is a specialized, geographically defined hospital unit dedicated to the management of patients with stroke. […] Stroke unit care is the gold standard for care following acute stroke. […] The core interdisciplinary stroke team should consist of healthcare professionals with stroke expertise including physicians, nurses, occupational therapists, physiotherapists, speech-language pathologists, social workers, dietitians, patients, and family members. […] All interdisciplinary stroke teams should include hospital pharmacists to promote patient safety; conduct medication reconciliation; provide education to the team and patients and families about medications and their side effects, adverse effects, and interactions; promote adherence; and participate in discharge planning which could include addressing special needs for patients, such as individual dosing packages.

• #1 Mobile stroke unit – Wikipedia

  https://en.wikipedia.org/wiki/Mobile_stroke_unit

  A mobile stroke unit (MSU) is an ambulance that furnishes services to diagnose, evaluate, and/or treat symptoms of an acute stroke. […] This specialized ambulance includes all the tools necessary for hyperacute assessment and treatment of stroke patients and diagnosis-based triage directly at the emergency site. […] As a potential solution to the problem of detrimental delays in stroke management the MSU concept was developed enabling diagnosis and treatment directly at the emergency site as opposed to awaiting the patient’s arrival at hospital for treatment. […] By bringing imaging technology and stroke clinical expertise to the scene, teams are able to take advantage of the pre-hospital arrival time by focusing team efforts solely on one patient with suspected stroke. […] Apart from the earlier start of treatment, knowledge about the type of stroke already in the pre-hospital phase of stroke management allows accurate triage decisions in regard to the most appropriate target hospital, e.g., hospital with or without endovascular or neurosurgical treatment options.

• #1

  https://journals.lww.com/nursingmadeincrediblyeasy/fulltext/2024/09000/nursing_management_of_acute_ischemic_stroke.2.aspx

  An acute ischemic stroke is a life-threatening and life-altering medical emergency. The role of the nurse includes assessment, identification, monitoring, psychological support, and rehabilitation for the patient, family, and caregivers. […] Given the statistics, the role of the nurse in managing strokes has never been more important. This article will focus on nursing care outside of the intensive care setting. […] The nurse plays a vital role by providing necessary information to the stroke or rapid response team upon their arrival. The nurse’s ability to communicate with the patient and other healthcare personnel is critical to the expedient nature of stroke care. […] Nurses need to perform ongoing neurologic exams with comparison to baseline. This includes serial NIHSS. […] Good oral hygiene protocols, pulmonary toileting, and early mobility will prevent stroke-associated pneumonia.

• #1 Updated guidance confirms crucial role of nurses for patients with acute ischemic stroke | American Heart Association

  https://newsroom.heart.org/news/updated-guidance-confirms-crucial-role-of-nurses-for-patients-with-acute-ischemic-stroke

  Three scientific statements provide newer, evidence-based suggestions for practices and assessment tools that offer guidance for nurses to provide comprehensive care for patients with acute ischemic stroke. […] Close monitoring of patients with acute ischemic stroke by nurses before, during and after procedures to dissolve or remove blood clots is indicated to achieve optimal patient outcomes. […] Nurses coordinate patient assessment and collaborate care among multiple health care professionals to facilitate the best possible outcomes for patients with acute ischemic stroke. […] Nurses serve in a critical role during a patients stroke treatment by providing communication and care prior to, during and after medical procedures. […] Nursing care and identification of patient changes is key during this time.

• #1 Key Points of Nursing Care for Patients with Acute Stroke | IntechOpen

  https://www.intechopen.com/chapters/87202

  The collaboration between neurosurgeons and certified stroke nurses has resulted in the development of 52 key points of nursing care for patients with acute stroke. […] The nurses role is to inform the therapist of any changes in the patient that affect training. […] Nurses must perform continuous monitoring of respiratory status in patients with acute stroke. […] Nurses need to alleviate physical pain as much as possible with pharmacologic and nonpharmacologic nursing care. […] Nurses should also implement safety without overloading the patient, such as in the prevention of deep vein thrombosis, aspiration pneumonia, bedsores, and joint contractures, especially when the patients condition is unstable and aggressive rehabilitation cannot be initiated. […] Nurses are responsible for planning the transition of stroke patients from the acute phase to a specialized rehabilitation facility or discharge to home. […] Thus, nurses should understand the differences in risk factors for recurrence according to stroke type.

• #1 Imperative Care launches new dual aspiration technology for stroke treatment

  https://www.medicaleconomics.com/view/imperative-care-launches-new-dual-aspiration-technology-for-stroke-treatment

  Zoom DuoPort enables simultaneous aspiration through two catheters, enhancing control and feedback during stroke thrombectomy procedures. […] The Zoom System, with large-bore catheters, has demonstrated rapid reperfusion times, improving treatment efficiency for acute ischemic stroke. […] Recent advancements in stroke care, including mechanical thrombectomy and improved imaging, have significantly enhanced patient outcomes. […] Coordinated care models and emerging technologies continue to advance stroke treatment, reducing disability and expanding access. […] Imperative Care enhances stroke treatment with Zoom DuoPort, enabling efficient dual aspiration for faster, more effective thrombectomy procedures. […] CDAT offers physicians improved control and real-time feedback during procedures, streamlining treatment for patients with acute ischemic stroke.

• #1 Imperative Care launches new dual aspiration technology for stroke treatment

  https://www.medicaleconomics.com/view/imperative-care-launches-new-dual-aspiration-technology-for-stroke-treatment

  The launch of CDAT and Zoom DuoPort is the result of our direct partnership with physicians who participated in the Imperative Trial and provided feedback on the need to make their procedures more efficient when applying aspiration to two Zoom catheters at the same time. […] The company cited data from the Imperative Trial showing that dual aspiration with the Zoom system achieved a 19-minute median time from groin puncture to mTICI 2B reperfusion, reportedly the fastest in major prospective mechanical thrombectomy trials. […] One of the most transformative developments has been the widespread adoption of mechanical thrombectomy, a minimally invasive procedure that physically removes clots from blocked vessels. […] Thrombectomy is now recommended for a broader population, including those with large vessel occlusions and extended time windows of up to 24 hours from symptom onset, provided imaging confirms salvageable brain tissue.

• #1 Imperative Care launches new dual aspiration technology for stroke treatment

  https://www.medicaleconomics.com/view/imperative-care-launches-new-dual-aspiration-technology-for-stroke-treatment

  Newer thrombectomy devices feature larger, more flexible catheters that can navigate tortuous anatomy and extract clots more efficiently. […] Innovations such as aspiration catheters, which use suction to remove clots, and stent retrievers, which trap and pull out blockages, have become standard tools. […] Some systems now allow dual aspiration or provide real-time feedback from within the sterile field, further improving procedural success and speed. […] These collective advances have dramatically improved the odds for stroke patients, reducing long-term disability and expanding treatment access across broader geographic and demographic groups.

• #1 AI in Stroke Treatment: Expert Insights from Henry Ford Health | AHA

  https://www.aha.org/advancing-health-podcast/2025-05-05-ai-stroke-treatment-expert-insights-henry-ford-health

  There’s a common saying in neurology and stroke care that time is brain. It is estimated that millions of neurons are irreplaceably lost each minute during an ischemic stroke. So the sooner that we are able to diagnose and treat a stroke, the more brain we’re able to save and the patients are able to have a easier outcome and a better recovery. […] AI has been used in multiple ways across medicine. In stroke care particularly, we’re able to use it in helping with diagnosis of stroke in a timely manner. Our program specifically is called Rapid AI. It is a software program that allows for quicker diagnosis of strokes and also facilitates communication between physicians. […] Particularly with ischemic strokes, the issue is trying to figure out what part of the brain has been affected by the stroke and also where the blood clot is.

• #1 AI in Stroke Treatment: Expert Insights from Henry Ford Health | AHA

  https://www.aha.org/advancing-health-podcast/2025-05-05-ai-stroke-treatment-expert-insights-henry-ford-health

  The program serves multiple purposes. The AI portion of the program evaluates the CT angiogram and the CT perfusion studies of the patient looking for any asymmetry in blood vessel distribution or perfusion. This is able to allow us to quickly evaluate for signs of what we call a large vessel occlusion. Those are the types of strokes that are most amenable to the thrombectomy procedure. […] Approximately 30 minutes. When we look at patients who are candidates for mechanical thrombectomy, that’s the procedure where we pull the clots from the brain. We’ve reduced our door-to-puncture time. […] Tremendous patient outcomes. If you look nationally, but also at our sites, you look at the number of patients, proportion of patients who recover to normal or nearly normal has increased. […] I don’t think that AI will ever replace physician assessment and judgment, but it’s very impressive what a powerful tool it can be when used appropriately, to improve the care that we provide to our patients.

• #1

  https://journals.lww.com/nursingmadeincrediblyeasy/fulltext/2024/09000/nursing_management_of_acute_ischemic_stroke.2.aspx

  Nurses are instrumental in providing ongoing education to stroke patients and their families. Education regarding risk factor reduction that has been individualized to the patient is critical in secondary stroke prevention. […] The role of nurses on stroke units includes assessment, identification, monitoring, psychological support, and rehabilitation for the patient and often their families and caregivers. […] Nurses who work with stroke patients require continuing education to maintain competency.

• #2 Stroke – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/stroke/symptoms-causes/syc-20350113

  Every stroke is different, and so every person’s road to recovery is different. Management of a stroke often involves a care team with several specialties. This may include a neurologist and a physical medicine and rehabilitation physician, among others. […] A stroke is a medical emergency. It’s crucial to get medical treatment right away. Getting emergency medical help quickly can reduce brain damage and other stroke complications. […] If you have had an ischemic stroke, you may need medicines to help lower your risk of having another stroke. If you have had a TIA, medicines can lower your risk of having a stroke in the future. These medicines may include: Anti-platelet drugs. […] If you’ve had a TIA or minor stroke, you may take both an aspirin and an anti-platelet medicine such as clopidogrel (Plavix). These medicines may be prescribed for a period of time to reduce the risk of another stroke. […] Stroke care at Mayo Clinic.

• #2 How CT Scans Help With Stroke Diagnosis and Treatment | Banner

  https://www.bannerhealth.com/healthcareblog/teach-me/how-ct-scans-help-with-stroke-diagnosis-and-treatment

  If you or someone you love has signs of a stroke, its important to get care right away. […] A key tool in finding strokes is a CT scan (computed tomography scan), said Savdeep Singh, MD, a neurologist with Banner – University Medicine. […] A CT scan helps health care providers see what kind of stroke a person is having. That way, they can recommend the right treatment. […] A CT scan is a painless test that uses X-rays to make detailed pictures of the brain. If you come to the hospital with stroke symptoms, a CT scan may be one of the first tests you get. […] It can show changes that are signs of ischemic strokes and the bleeding that can happen with a hemorrhagic stroke, Dr. Singh said. […] Different types of strokes need different treatments. A CT scan helps doctors quickly see if a stroke is ischemic or hemorrhagic, so they can act fast:

• #2 Stroke (CVA): Nursing Diagnoses, Care Plans, Assessment & Interventions | NurseTogether

  https://www.nursetogether.com/stroke-cerebrovascular-accident-nursing-diagnosis-care-plan/

  Patients will have varying levels of disability following a stroke, depending on the severity of the stroke, length of time before treatment was started, and pre-existing conditions. […] The nurse utilizes compassionate care to maintain patient safety and dignity while managing their physical and psychosocial needs. […] Nursing interventions and care are essential for the patients recovery. […] Following a stroke, frequent neurologic assessments allow the nurse to observe for changes in a patients neurologic status and intervene promptly. […] Secondary events such as hypertensive crisis, re-bleeding in the brain, seizures, and constipation will be important for the nurse to prevent. […] The recommended blood pressure range for the first 24 hours following IV alteplase is less than 180/105 mm Hg.

• #2 14 Stroke (CVA) Nursing Diagnosis and Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cerebrovascular-accident-stroke-nursing-care-plans/

  Observe the affected side for color, edema, or other signs of compromised circulation. […] Inspect skin regularly, particularly over bony prominences. […] Change positions at least every two hours (supine, side-lying) and possibly more often if placed on the affected side. […] Position in a prone position once or twice a day if the client can tolerate it. […] Prop extremities in a functional position; use the footboard during the period of flaccid paralysis. […] Use an arm sling when the client is in an upright position, as indicated. […] Evaluate the need for positional aids and splints during spastic paralysis. […] Place a pillow under the axilla to abduct the arm. […] Elevate arm and hand. […] Place hard hand rolls in the palm with fingers and thumb as opposed. […] Place the knee and hip in an extended position.

• #2 14 Stroke (CVA) Nursing Diagnosis and Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cerebrovascular-accident-stroke-nursing-care-plans/

  Prevent straining at stool, holding breath, and physical exertion. […] Stress smoking cessation. […] Administer supplemental oxygen as indicated. […] Administer medications and insulin as indicated. […] Monitor laboratory studies as indicated: prothrombin time (PT), activated partial thromboplastin time (aPTT), and Dilantin level. […] Prepare for surgery, as appropriate. […] The goal of care for clients with limited physical mobility is to maintain and improve the clients functional abilities through maintaining normal functioning and alignment, reducing spasticity, preventing edema of extremities, and preventing complications of immobility. […] Assess the extent of impairment initially and functional ability. Classify according to a 0 to 4 scale. […] Monitor the lower extremities for symptoms of thrombophlebitis.

• #2 Nursing Interventions for the Stroke Patient (Powers et al., 2018)

  https://www.nursingcenter.com/clinical-resources/nursing-pocket-cards/assessment-and-management-of-stroke

  Hypotension and hypovolemia should be corrected to support organ function (Powers et al., 2019) and to prevent secondary brain injury. […] The following are not recommended to treat AIS (Powers et al., 2019): […] Treat hypertension early when comorbid conditions are present, such as concomitant acute coronary event, acute heart failure, aortic dissection, postfibrinolysis subarachnoid intracranial hemorrhage (sICH), or preeclampsia/eclampsia (Powers et al., 2019). […] If surgery is performed, assess the patient for the following and if present, notify the health care team immediately: […] Strategies to Minimize Post-Procedure Complications […] Nutrition (Powers et al., 2019) […] Start enteral feedings within 7 days of admission after an acute stroke. […] Screen for dysphagia with speech therapy consultation before the patient begins eating, drinking, or receiving oral medications to identify risk for aspiration.

• #2 14 Stroke (CVA) Nursing Diagnosis and Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cerebrovascular-accident-stroke-nursing-care-plans/

  Assess the client for signs of depression. […] Differentiate the clients symptoms from Alzheimer dementia symptoms. […] Listen for errors in conversation and provide feedback. […] Ask the client to write their name and a short sentence. […] Write a notice at the nurses station and the clients room about speech impairment. […] Provide alternative methods of communication. […] Talk directly to the client, speaking slowly and distinctly. […] Speak in normal tones and avoid talking too fast. […] Discuss familiar topics (e.g., weather, family, hobbies, jobs). […] Encourage significant others (SO) to continue communicating with the client: reading mail and discussing family happenings even if the client cannot respond appropriately. […] Eliminate extraneous noise and stimuli as necessary.

• #2 14 Stroke (CVA) Nursing Diagnosis and Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cerebrovascular-accident-stroke-nursing-care-plans/

  Avoid the use of overhead pulleys. […] Perform the therapeutic technique of range of movement by holding the humerus under the axilla and maintaining external rotation. […] Assist the client in performing range-of-motion exercises. […] Administer botulinum toxin A (BTX-A) as indicated. […] Administer oral pain medications as prescribed. […] Administer topical pain medications as indicated. […] Promote the benefits of exercise intervention programs. […] Educate the family members or caregivers about the proper positioning and handling of the clients affected areas. […] Teach the client and family members about shoulder strapping. […] Provide instructions about the Bobath method. […] Prepare the client for neuromuscular electrical stimulation (NMES). […] Physical, social, and cognitive impairment following a stroke may constitute a serious problem to the quality of life.

• #2 Stroke – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/stroke/diagnosis-treatment/drc-20350119

  Our caring team of Mayo Clinic experts can help you with your stroke-related health concerns. […] Most strokes are preventable. And stroke prevention is far more effective than trying to treat a stroke after it has occurred. […] The patient with a stroke will typically start therapies very early after a stroke, including physical therapy, occupational therapy, and speech therapy. […] If you have any stroke risk factors, partner with your medical team to control them. If stroke symptoms occur, seek emergency care. Work with your medical team to arrange for the appropriate evaluation to clarify why the stroke happened, and institute strategies to prevent another stroke from occurring in the future. […] After emergency treatment, you’re closely monitored for at least a day. After that, stroke care focuses on helping you recover as much function as possible and to return to independent living.

• #2 14 Stroke (CVA) Nursing Diagnosis and Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cerebrovascular-accident-stroke-nursing-care-plans/

  Maintain the leg in a neutral position with a trochanter roll. […] Discontinue the use of the footboard when appropriate. […] Assist the client in developing sitting and standing balance. […] Get the client up in a chair as soon as vital signs are stable, except following a cerebral hemorrhage. […] Position the client and align his extremities correctly. […] Provide egg-crate mattress, water bed, flotation device, or specialized beds, as indicated. […] Begin active or passive range-of-motion (ROM) exercises on admission to all extremities (including splinted). […] Encourage the client to assist with movement and exercises using unaffected extremities to support and move the weaker side. […] Assist the client with exercise and perform ROM exercises for both the affected and unaffected sides.

• #2 14 Stroke (CVA) Nursing Diagnosis and Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cerebrovascular-accident-stroke-nursing-care-plans/

  Assess the extent of altered perception and related degree of disability. […] Identify the meaning of the dysfunction and change to the client. […] Determine outside stressors: family, work, and future healthcare needs. […] Identify previous methods of dealing with life problems. […] Monitor for sleep disturbance, increased difficulty concentrating, statements of inability to cope, lethargy, and withdrawal. […] Note whether the client refers to the affected side as it or denies the affected side and says it is dead. […] Provide psychological support and set realistic short-term goals. […] Encourage the client to express feelings, including hostility or anger, denial, depression, sense of disconnectedness. […] Acknowledge the statement of feelings about the betrayal of the body; remain matter-of-fact about the reality that the client can still use the unaffected side and learn to control the affected side.

• #2 Nursing management with cva patient | PPT

  https://www.slideshare.net/slideshow/nursing-management-with-cva-patient/238334795

  Nursing Assessment During the acute phase, a neurologic flow sheet is maintained to provide data about the following important measures of the patients clinical status: Change in level of consciousness or responsiveness. […] Nursing Diagnosis Based on the assessment data, the major nursing diagnoses for a patient with stroke may include the following: Impaired physical mobility related to hemiparesis, loss of balance and coordination, spasticity, and brain injury. […] Evaluation Expected patient outcomes may include the following: Improved mobility. Absence of shoulder pain. Self-care achieved. Relief of sensory and perceptual deprivation. […] Discharge and Home Care Guidelines Patient and family education is a fundamental component of rehabilitation.

• #2 14 Stroke (CVA) Nursing Diagnosis and Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cerebrovascular-accident-stroke-nursing-care-plans/

  Emphasize small gains either in the recovery of function or independence. […] Support behaviors and efforts such as increased interest/participation in rehabilitation activities. […] Refer for neuropsychological evaluation and counseling if indicated. […] Promote the use of positive coping strategies. […] Prepare the client for mirror therapy. […] Provide information about peer support groups. […] Getting the right information about stroke was often of great importance to clients and caregivers and aided the processes of reassurance and adjustment. […] Assess the type and degree of sensory-perceptual involvement. […] Identify signs and symptoms requiring further follow-up: changes or decline in visual, motor, and sensory functions; alteration in mentation or behavioral responses; severe headache.

• #2 14 Stroke (CVA) Nursing Diagnosis and Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cerebrovascular-accident-stroke-nursing-care-plans/

  Encourage the client to refer to written communications or notes instead of depending on memory. […] Discuss plans for meeting self-care needs. […] Suggest clients reduce environmental stimuli, especially during cognitive activities. […] Recommend clients seek assistance in the problem-solving process and validate decisions, as indicated. […] Review the importance of a balanced diet, low in cholesterol and sodium if indicated. […] Reinforce the importance of follow-up care by rehabilitation teams: physical and occupational therapists, vocational therapists, speech therapists, and dieticians. […] Refer to a home care supervisor or a visiting nurse. […] Provide accessible and reliable community sources. […] Implement evidence-based methods of health education. […] Address the needs of family caregivers.

• #2 Acute Stroke (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568693/

  Nurses must coordinate care with these interprofessional team members to ensure functional assessments and speech/swallow assessments have been made for these patients with the implementation of recommended interventions. […] Educate the patient and caregiver on the following: Eating healthy, Do not lead a sedentary lifestyle, Observe compliance with medications, Follow up with a clinician, Do not smoke, Control blood pressure, blood glucose, and hyperlipidemia, Participate in regular exercise. […] Patients with a stroke can deteriorate rapidly. […] The nurse should monitor the patient closely for any new neurological deficit and inform the clinician. […] According to the American Heart Association and American Stroke Association, the following points are an essential part of the discharge discussion: Education regarding the causes of stroke, Education regarding modifiable risk factors for stroke, Education regarding blood pressure and glucose management, Education regarding healthy dietary intake, Education regarding the use of assistive devices, as advised by the therapy teams to prevent the risk of falls, Emphasizing medication compliance, Emphasizing follow-up compliance, Ensuring patients and caregivers understand the signs and symptoms of stroke to ensure timely evaluation in the event of a recurrent stroke.

• #2 Postdischarge nursing care of stroke patients

  https://www.myamericannurse.com/postdischarge-nursing-care-of-stroke-patients/

  Educate patients about lifestyle modifications that may improve their blood pressure, blood glucose, and blood cholesterol. […] Research highlights positive functional outcomes in stroke survivors receiving home health care but negative health outcomes for caregivers. […] Patient and family education, goal reinforcement, and communication with other healthcare team members about the patients needs and concerns are crucial to maximizing outcomes.

• #2 8. Acute Stroke Unit Care | Canadian Stroke Best Practices

  https://www.strokebestpractices.ca/recommendations/acute-stroke-management/acute-stroke-unit-care

  Patients admitted to hospital with an acute stroke or transient ischemic attack (TIA) should be treated on an inpatient stroke unit as soon as possible; ideally within 24 hours of hospital arrival. […] All efforts should be made to admit patients to an acute stroke unit, which is a specialized, geographically defined hospital unit dedicated to the management of patients with stroke. […] Stroke unit care is the gold standard for care following acute stroke. […] The core interdisciplinary stroke team should consist of healthcare professionals with stroke expertise including physicians, nurses, occupational therapists, physiotherapists, speech-language pathologists, social workers, dietitians, patients, and family members. […] All interdisciplinary stroke teams should include hospital pharmacists to promote patient safety; conduct medication reconciliation; provide education to the team and patients and families about medications and their side effects, adverse effects, and interactions; promote adherence; and participate in discharge planning which could include addressing special needs for patients, such as individual dosing packages.

• #2 Stroke Care | Stroke Centers in Durham and Raleigh, NC

  https://www.dukehealth.org/treatments/neurological-disorders/stroke

  A stroke is a medical emergency that requires urgent attention. If you suspect you or a loved one may be having stroke symptoms, call 911 immediately to get fast, lifesaving treatment. […] Emergency stroke care is provided at our hospitals’ emergency room locations in Durham and Raleigh. […] Duke experts provide coordinated stroke recovery and rehabilitation care. […] Designated stroke centers follow the groups recommendations and guidelines and have established ways to measure improvements in stroke care and patient outcomes. […] Duke University Hospital is a certified Comprehensive Stroke Center. […] Duke Raleigh Hospital, a campus of Duke University Hospital, is a certified Primary Stroke Center. […] Duke Regional Hospital is a certified Primary Stroke Center. […] Duke University Hospital received a 2024 AHA/ASA „Get with the Guidelines-Stroke Gold Plus” award. […] Duke Regional Hospital received the „Silver Plus with Honor Roll Elite” award. […] As national leaders in stroke research, our stroke specialists help to write the national guidelines for stroke prevention and treatment.

• #2 Mobile stroke unit – Wikipedia

  https://en.wikipedia.org/wiki/Mobile_stroke_unit

  A mobile stroke unit (MSU) is an ambulance that furnishes services to diagnose, evaluate, and/or treat symptoms of an acute stroke. […] This specialized ambulance includes all the tools necessary for hyperacute assessment and treatment of stroke patients and diagnosis-based triage directly at the emergency site. […] As a potential solution to the problem of detrimental delays in stroke management the MSU concept was developed enabling diagnosis and treatment directly at the emergency site as opposed to awaiting the patient’s arrival at hospital for treatment. […] By bringing imaging technology and stroke clinical expertise to the scene, teams are able to take advantage of the pre-hospital arrival time by focusing team efforts solely on one patient with suspected stroke. […] Apart from the earlier start of treatment, knowledge about the type of stroke already in the pre-hospital phase of stroke management allows accurate triage decisions in regard to the most appropriate target hospital, e.g., hospital with or without endovascular or neurosurgical treatment options.

• #2 Updated guidance confirms crucial role of nurses for patients with acute ischemic stroke | American Heart Association

  https://newsroom.heart.org/news/updated-guidance-confirms-crucial-role-of-nurses-for-patients-with-acute-ischemic-stroke

  Three scientific statements provide newer, evidence-based suggestions for practices and assessment tools that offer guidance for nurses to provide comprehensive care for patients with acute ischemic stroke. […] Close monitoring of patients with acute ischemic stroke by nurses before, during and after procedures to dissolve or remove blood clots is indicated to achieve optimal patient outcomes. […] Nurses coordinate patient assessment and collaborate care among multiple health care professionals to facilitate the best possible outcomes for patients with acute ischemic stroke. […] Nurses serve in a critical role during a patients stroke treatment by providing communication and care prior to, during and after medical procedures. […] Nursing care and identification of patient changes is key during this time.

• #2 Time is brain

  https://www.myamericannurse.com/time-is-brain/

  Patients with AIS have complex, multisystem needs that inform nursing priorities throughout hospitalization. […] Blood pressure management is crucial in stroke patients. […] Additional supportive elements of post-stroke care include reducing fever burden and maintaining glycemic control. […] Patients who’ve experienced a stroke may be at increased risk for immobility, skin breakdown, and bowel or bladder dysfunction. […] Acute stroke, a medical emergency, requires urgent attention and well-coordinated care. […] Nurses are vital to the initial and ongoing care of these patients.

• #2

  https://journals.lww.com/nursingmadeincrediblyeasy/fulltext/2024/09000/nursing_management_of_acute_ischemic_stroke.2.aspx

  Nurses are instrumental in providing ongoing education to stroke patients and their families. Education regarding risk factor reduction that has been individualized to the patient is critical in secondary stroke prevention. […] The role of nurses on stroke units includes assessment, identification, monitoring, psychological support, and rehabilitation for the patient and often their families and caregivers. […] Nurses who work with stroke patients require continuing education to maintain competency.

• #2 Cerebrovascular Accident (Stroke) Nursing Care and Management: A Study Guide

  https://nurseslabs.com/cerebrovascular-accident-stroke/

  Learn about the nursing care management of patients with cerebrovascular accident in this nursing study guide. […] After the stroke is complete, management focuses on the prompt initiation of rehabilitation for any deficits. […] During the acute phase, a neurologic flow sheet is maintained to provide data about the following important measures of the patients clinical status: Change in level of consciousness or responsiveness. […] Based on the assessment data, the major nursing diagnoses for a patient with stroke may include the following: Impaired physical mobility related to hemiparesis, loss of balance and coordination, spasticity, and brain injury. […] The major nursing care planning goals for the patient and family may include: Improve mobility. […] Nursing care has a significant impact on the patients recovery.

• #2 AANN Advances in Stroke Care Conference | AANN

  https://aann.org/meetings/stroke-conference

  Get relevant stroke nursing education for you and your team. […] If you are involved in the care of stroke patientswhether you are an advanced practice nurse, a stroke coordinator or administrator, a critical care neuroscience nurse, a nurse new to stroke care, or someone preparing for the Stroke Certified Registered Nurse (SCRN) examinationthis conference will help you achieve your educational goals. […] The premier conference for stroke nursing education […] Overall great information to improve quality outcomes to benefit the patients and improve the quality of care that the nursing team provides.

• #2 8. Acute Stroke Unit Care | Canadian Stroke Best Practices

  https://www.strokebestpractices.ca/recommendations/acute-stroke-management/acute-stroke-unit-care

  The patient and family should be included as part of the core team. […] All professional members of the interdisciplinary stroke team should have specialized training in stroke care and recovery. […] The interdisciplinary stroke team should assess all patients as soon as possible after admission to hospital, and ideally within 48 hours, and formulate a management plan. […] Assessments of impairment, functional activity limitations, role participation restrictions, and environmental factors should be conducted using standardized, valid assessment tools. […] Patients should have a formal and individualized assessment to determine the type of ongoing post-acute rehabilitation services they require as soon as their status has stabilized, and within the first 72 hours post-stroke, using a standardized protocol.

• #3 Nursing Care for Stroke Patients: Current Practice and Future Needs

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10535295/

  Background: Stroke is the second leading cause of death and the third leading cause of disability worldwide. Stroke nurses play an important role in the care of patients living with stroke by using best practices and adhering to stroke-management guidelines. This study aims at examining the current nursing practice for stroke patients in Saudi Arabia. […] Stroke nurses play a significant role in the care of stroke patients through appropriate practices, starting from following stroke-management guidelines in providing advanced care to stroke patients. Additionally, they focus on the patients comprehensive care from the point the patient is admitted into the hospital until the patient is discharged to a rehabilitation department. Furthermore, stroke nurses provide a plan of care to ensure continuity of care for stroke patients after discharge. Therefore, implementing a stroke-care system will ensure advanced stroke management and provision of a high quality of care during acute and recovery care.

• #3

  https://journals.lww.com/nursingmadeincrediblyeasy/fulltext/2024/09000/nursing_management_of_acute_ischemic_stroke.2.aspx

  An acute ischemic stroke is a life-threatening and life-altering medical emergency. The role of the nurse includes assessment, identification, monitoring, psychological support, and rehabilitation for the patient, family, and caregivers. […] Given the statistics, the role of the nurse in managing strokes has never been more important. This article will focus on nursing care outside of the intensive care setting. […] The nurse plays a vital role by providing necessary information to the stroke or rapid response team upon their arrival. The nurse’s ability to communicate with the patient and other healthcare personnel is critical to the expedient nature of stroke care. […] Nurses need to perform ongoing neurologic exams with comparison to baseline. This includes serial NIHSS. […] Good oral hygiene protocols, pulmonary toileting, and early mobility will prevent stroke-associated pneumonia.

• #3 Stroke (CVA): Nursing Diagnoses, Care Plans, Assessment & Interventions | NurseTogether

  https://www.nursetogether.com/stroke-cerebrovascular-accident-nursing-diagnosis-care-plan/

  Patients will have varying levels of disability following a stroke, depending on the severity of the stroke, length of time before treatment was started, and pre-existing conditions. […] The nurse utilizes compassionate care to maintain patient safety and dignity while managing their physical and psychosocial needs. […] Nursing interventions and care are essential for the patients recovery. […] Following a stroke, frequent neurologic assessments allow the nurse to observe for changes in a patients neurologic status and intervene promptly. […] Secondary events such as hypertensive crisis, re-bleeding in the brain, seizures, and constipation will be important for the nurse to prevent. […] The recommended blood pressure range for the first 24 hours following IV alteplase is less than 180/105 mm Hg.

• #3 14 Stroke (CVA) Nursing Diagnosis and Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cerebrovascular-accident-stroke-nursing-care-plans/

  Maintain the leg in a neutral position with a trochanter roll. […] Discontinue the use of the footboard when appropriate. […] Assist the client in developing sitting and standing balance. […] Get the client up in a chair as soon as vital signs are stable, except following a cerebral hemorrhage. […] Position the client and align his extremities correctly. […] Provide egg-crate mattress, water bed, flotation device, or specialized beds, as indicated. […] Begin active or passive range-of-motion (ROM) exercises on admission to all extremities (including splinted). […] Encourage the client to assist with movement and exercises using unaffected extremities to support and move the weaker side. […] Assist the client with exercise and perform ROM exercises for both the affected and unaffected sides.

• #3 Nursing Interventions for the Stroke Patient (Powers et al., 2018)

  https://www.nursingcenter.com/clinical-resources/nursing-pocket-cards/assessment-and-management-of-stroke

  For patients with dysphagia, use nasogastric tubes for feeding in early phase of stroke (first 7 days); percutaneous gastrostomy tube may be needed if unable to swallow safely for longer than 2-3 weeks. […] Consider nutritional supplements for patients who are at risk for malnourishment. […] Additional Recommendations (Powers et al., 2018) […] Screen for post-stroke depression and administer antidepressants if not contraindicated. […] Avoid routine use of indwelling bladder catheters to prevent catheter-associated urinary tract infections. […] Perform regular skin assessments during hospitalization and inpatient rehabilitation. […] Initiate early rehabilitation for hospitalized stroke patients; facilitate and prioritize physical and occupational therapy evaluations and assist with implementation of treatment plans

• #3 Cerebrovascular Accident (Stroke) Nursing Care and Management: A Study Guide

  https://nurseslabs.com/cerebrovascular-accident-stroke/

  Here are some nursing interventions for patients with stroke: Positioning. […] Consult with a speech therapist to evaluate gag reflexes and assist in teaching alternate swallowing techniques. […] Provide emotional support and encouragement to prevent fatigue and discouragement. […] Patient and family education is a fundamental component of rehabilitation. […] Nurses should assess caregivers for signs of depression, as depression is also common among caregivers of stroke survivors.

• #3 14 Stroke (CVA) Nursing Diagnosis and Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cerebrovascular-accident-stroke-nursing-care-plans/

  Identify individual risk factors (e.g., hypertension, cardiac dysrhythmias, obesity, smoking, heavy alcohol use, atherosclerosis, poor control of diabetes, use of oral contraceptives) and discuss necessary lifestyle changes. […] Assess the clients and family members health literacy. […] Include significant others (SO) and the family in discussions and teaching. […] Discuss specific pathology and individual potentials. […] Review current restrictions and discuss the potential resumption of activities (including sexual relations). […] Reinforce the current therapeutic regimen, including using medications to control hypertension, hypercholesterolemia, and diabetes, as indicated; aspirin or similar-acting drugs, for example, ticlopidine, warfarin sodium. […] Provide written instructions and schedules for activity, medication, and essential facts.

• #3 8. Acute Stroke Unit Care | Canadian Stroke Best Practices

  https://www.strokebestpractices.ca/recommendations/acute-stroke-management/acute-stroke-unit-care

  The patient and family should be included as part of the core team. […] All professional members of the interdisciplinary stroke team should have specialized training in stroke care and recovery. […] The interdisciplinary stroke team should assess all patients as soon as possible after admission to hospital, and ideally within 48 hours, and formulate a management plan. […] Assessments of impairment, functional activity limitations, role participation restrictions, and environmental factors should be conducted using standardized, valid assessment tools. […] Patients should have a formal and individualized assessment to determine the type of ongoing post-acute rehabilitation services they require as soon as their status has stabilized, and within the first 72 hours post-stroke, using a standardized protocol.

• #3 8. Acute Stroke Unit Care | Canadian Stroke Best Practices

  https://www.strokebestpractices.ca/recommendations/acute-stroke-management/acute-stroke-unit-care

  Stroke unit care is characterized by a coordinated interdisciplinary team comprising physicians, nurses, physiotherapists, occupational therapists, speech-language pathologists, and pharmacists, among others. […] Patients treated on stroke units experience fewer complications and receive rehabilitation therapies earlier. […] Stroke unit care is associated with reductions in the likelihood of death, death and disability, and death or the need for institutionalization by approximately 25%. […] It is well-established that patients who receive stroke unit care are more likely to survive, return home, and regain independence compared to patients who receive less organized forms of care. […] Stroke unit care was associated with a significant reduction in the odds of death, a poor outcome, and death or dependency at a median follow-up of one year.

• #4 Acute Stroke (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568693/

  A cerebrovascular accident, more commonly known as a stroke, is broadly classified as either ischemic or hemorrhagic. […] With early, focused treatment based on the stroke etiology, rehabilitation programs, and long-term lifestyle changes, one can maximize their chances for a meaningful recovery. […] List the nursing needs of a patient with a stroke. […] Nursing Diagnosis: Inadequate cerebral perfusion, Impaired ability to communicate, Impairment in physical mobility, Altered sensory perception, Inability to perform daily living activities, Impaired swallowing, Ineffective coping. […] Assess mental status and level of consciousness. […] Observe for neurological deficits with frequent and serial neurological assessments. […] Provide deep vein thrombosis (DVT) prophylaxis. […] During the time-dependent early stroke phase and rehabilitation, stroke care involves an interprofessional team to prevent the disease.

• #4 Time is brain

  https://www.myamericannurse.com/time-is-brain/

  Patients with AIS have complex, multisystem needs that inform nursing priorities throughout hospitalization. […] Blood pressure management is crucial in stroke patients. […] Additional supportive elements of post-stroke care include reducing fever burden and maintaining glycemic control. […] Patients who’ve experienced a stroke may be at increased risk for immobility, skin breakdown, and bowel or bladder dysfunction. […] Acute stroke, a medical emergency, requires urgent attention and well-coordinated care. […] Nurses are vital to the initial and ongoing care of these patients.

• #4 14 Stroke (CVA) Nursing Diagnosis and Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cerebrovascular-accident-stroke-nursing-care-plans/

  Maintain the leg in a neutral position with a trochanter roll. […] Discontinue the use of the footboard when appropriate. […] Assist the client in developing sitting and standing balance. […] Get the client up in a chair as soon as vital signs are stable, except following a cerebral hemorrhage. […] Position the client and align his extremities correctly. […] Provide egg-crate mattress, water bed, flotation device, or specialized beds, as indicated. […] Begin active or passive range-of-motion (ROM) exercises on admission to all extremities (including splinted). […] Encourage the client to assist with movement and exercises using unaffected extremities to support and move the weaker side. […] Assist the client with exercise and perform ROM exercises for both the affected and unaffected sides.

• #4 Nursing Care for Stroke Patients: Current Practice and Future Needs

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10535295/

  According to previous studies on the early management of patients with stroke, one of the important members of the stroke-management team is the nursing staff. […] Poststroke nursing care focuses on rehabilitation services and secondary prevention measures to enhance stroke survivors outcomes and avoid stroke recurrence. […] The nurses role is to follow up with the patient during the recovery phase to ensure continuity of care. […] Therefore, nursing care practice should also focus on following up with stroke survivors to reduce the risk of readmission and improve the quality of survivors lives. […] According to the AHA and the American Stroke Associations (ASA) scientific statement, depression following a stroke is a dynamic phenomenon that affects up to one-third of stroke survivors.

• #4 8. Acute Stroke Unit Care | Canadian Stroke Best Practices

  https://www.strokebestpractices.ca/recommendations/acute-stroke-management/acute-stroke-unit-care

  The patient and family should be included as part of the core team. […] All professional members of the interdisciplinary stroke team should have specialized training in stroke care and recovery. […] The interdisciplinary stroke team should assess all patients as soon as possible after admission to hospital, and ideally within 48 hours, and formulate a management plan. […] Assessments of impairment, functional activity limitations, role participation restrictions, and environmental factors should be conducted using standardized, valid assessment tools. […] Patients should have a formal and individualized assessment to determine the type of ongoing post-acute rehabilitation services they require as soon as their status has stabilized, and within the first 72 hours post-stroke, using a standardized protocol.

• #5 14 Stroke (CVA) Nursing Diagnosis and Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cerebrovascular-accident-stroke-nursing-care-plans/

  Cerebrovascular Accident (Stroke) Nursing Care Plans and Nursing DiagnosisCerebrovascular Accident (Stroke) Nursing Care Plans and Nursing Diagnosis […] Use this nursing care plan and management guide to help care for patients with cerebrovascular accident (CVA). Enhance your understanding of nursing assessment, interventions, goals, and nursing diagnosis, all specifically tailored to address the unique needs of individuals facing cerebrovascular accident (CVA). […] The primary nursing care plan goals for clients with stroke depend on the phase of CVA the client is in. During the acute phase of CVA, efforts should focus on survival needs and prevent further complications. Care revolves around efficient continuing neurologic assessment, support of respiration, continuous monitoring of vital signs, careful positioning to avoid aspiration and contractures, management of GI problems, and monitoring of electrolyte and nutritional status. Nursing care should also include measures to prevent complications.

• #5 Nursing Interventions for the Stroke Patient (Powers et al., 2018)

  https://www.nursingcenter.com/clinical-resources/nursing-pocket-cards/assessment-and-management-of-stroke

  Hypotension and hypovolemia should be corrected to support organ function (Powers et al., 2019) and to prevent secondary brain injury. […] The following are not recommended to treat AIS (Powers et al., 2019): […] Treat hypertension early when comorbid conditions are present, such as concomitant acute coronary event, acute heart failure, aortic dissection, postfibrinolysis subarachnoid intracranial hemorrhage (sICH), or preeclampsia/eclampsia (Powers et al., 2019). […] If surgery is performed, assess the patient for the following and if present, notify the health care team immediately: […] Strategies to Minimize Post-Procedure Complications […] Nutrition (Powers et al., 2019) […] Start enteral feedings within 7 days of admission after an acute stroke. […] Screen for dysphagia with speech therapy consultation before the patient begins eating, drinking, or receiving oral medications to identify risk for aspiration.

• #5 14 Stroke (CVA) Nursing Diagnosis and Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cerebrovascular-accident-stroke-nursing-care-plans/

  Maintain the leg in a neutral position with a trochanter roll. […] Discontinue the use of the footboard when appropriate. […] Assist the client in developing sitting and standing balance. […] Get the client up in a chair as soon as vital signs are stable, except following a cerebral hemorrhage. […] Position the client and align his extremities correctly. […] Provide egg-crate mattress, water bed, flotation device, or specialized beds, as indicated. […] Begin active or passive range-of-motion (ROM) exercises on admission to all extremities (including splinted). […] Encourage the client to assist with movement and exercises using unaffected extremities to support and move the weaker side. […] Assist the client with exercise and perform ROM exercises for both the affected and unaffected sides.

• #6 14 Stroke (CVA) Nursing Diagnosis and Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cerebrovascular-accident-stroke-nursing-care-plans/

  Therapeutic interventions and nursing actions for patients with cerebrovascular accident (CVA) may include: Assessing and Monitoring Mental Status […] Assess airway patency and respiratory pattern. Neurologic deficits of a stroke may include loss of gag reflex or cough reflex; thus, airway patency and breathing pattern must be part of the initial assessment. Clients with a decreased level of consciousness should be assessed to ensure that they are able to protect their airways. […] Assess factors related to decreased cerebral perfusion and the potential for increased intracranial pressure (ICP). […] Recognize the clinical manifestations of a transient ischemic attack (TIA). […] Frequently assess and monitor neurological status. […] Monitor changes in blood pressure, and compare BP readings in both arms.

• #6 Nursing Interventions for the Stroke Patient (Powers et al., 2018)

  https://www.nursingcenter.com/clinical-resources/nursing-pocket-cards/assessment-and-management-of-stroke

  In the United States, stroke is the fifth leading cause of death and the leading cause of disability (Centers for Disease Control and Prevention [CDC], 2023). Early identification, evaluation and treatment of stroke reduces motor and cognitive deficits and lowers mortality. Use this nursing pocket card to assist in the identification and treatment of stroke. […] Nursing Interventions for the Stroke Patient (Powers et al., 2018) […] Support airway, breathing, and circulation […] Monitor vital signs at least every 15 minutes initially, as directed by your facility. […] Neurologic assessments should be performed hourly and as needed. […] Treat hyperthermia (temperature greater than 38 degrees Celsius) with antipyretic medications. […] Treat hyperglycemia to keep blood glucose levels between 140-180 mg/dL and treat hypoglycemia (blood glucose less than 60 mg/dL), as directed by your facility.

• #7 Nursing Interventions for the Stroke Patient (Powers et al., 2018)

  https://www.nursingcenter.com/clinical-resources/nursing-pocket-cards/assessment-and-management-of-stroke

  In the United States, stroke is the fifth leading cause of death and the leading cause of disability (Centers for Disease Control and Prevention [CDC], 2023). Early identification, evaluation and treatment of stroke reduces motor and cognitive deficits and lowers mortality. Use this nursing pocket card to assist in the identification and treatment of stroke. […] Nursing Interventions for the Stroke Patient (Powers et al., 2018) […] Support airway, breathing, and circulation […] Monitor vital signs at least every 15 minutes initially, as directed by your facility. […] Neurologic assessments should be performed hourly and as needed. […] Treat hyperthermia (temperature greater than 38 degrees Celsius) with antipyretic medications. […] Treat hyperglycemia to keep blood glucose levels between 140-180 mg/dL and treat hypoglycemia (blood glucose less than 60 mg/dL), as directed by your facility.

• #7 Nursing Care Plan For Stroke – Made For Medical

  https://www.madeformedical.com/nursing-care-plan-for-stroke/

  Blood pressure is a critical vital sign in the AIS patient and thus It is not uncommon to see variations in blood pressure after AIS. […] Fever appears to exacerbate the ischemic injury to neurons and is associated with increased morbidity and mortality, particularly in acute stroke. […] The monitoring of oxygen saturation will reduce the risk of neurological deterioration related to hypoxemia. […] Improving mobility and preventing deformities position thus to prevent contractures. […] Provide a full range of motion four or five times a day to maintain joint mobility. […] A range of motion exercises are beneficial but avoid over strenuous arm movements. […] Help the patient to set realistic goals; add a new task daily. […] Patient for paroxysms of coughing, food dribbling out or pooling in one side of the mouth, and therefore, food retained for long periods in the mouth, or nasal regurgitation when swallowing liquids.

• #8 14 Stroke (CVA) Nursing Diagnosis and Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/cerebrovascular-accident-stroke-nursing-care-plans/

  Monitor heart rate and rhythm, and assess for murmurs. […] Monitor respirations, noting patterns and rhythm, Cheyne-Stokes respiration. […] Evaluate pupils, noting size, shape, equality, and light reactivity. […] Document changes in vision: reports of blurred vision, alterations in the visual field, and depth perception. […] Assess higher functions, including speech, if the client is alert. […] Assess for nuchal rigidity, twitching, increased restlessness, irritability, and the onset of seizure activity. […] Use the National Institutes of Health Stroke Scale (NIHSS) for assessing neurologic impairment. […] Screen the client for stroke risk. […] Monitor blood glucose levels. […] Position with head slightly elevated and in a neutral position. […] Maintain bedrest, provide a quiet and relaxing environment, and restrict visitors and activities.

• #8 Nursing Care Plan For Stroke – Made For Medical

  https://www.madeformedical.com/nursing-care-plan-for-stroke/

  Blood pressure is a critical vital sign in the AIS patient and thus It is not uncommon to see variations in blood pressure after AIS. […] Fever appears to exacerbate the ischemic injury to neurons and is associated with increased morbidity and mortality, particularly in acute stroke. […] The monitoring of oxygen saturation will reduce the risk of neurological deterioration related to hypoxemia. […] Improving mobility and preventing deformities position thus to prevent contractures. […] Provide a full range of motion four or five times a day to maintain joint mobility. […] A range of motion exercises are beneficial but avoid over strenuous arm movements. […] Help the patient to set realistic goals; add a new task daily. […] Patient for paroxysms of coughing, food dribbling out or pooling in one side of the mouth, and therefore, food retained for long periods in the mouth, or nasal regurgitation when swallowing liquids.

• #9 Cerebrovascular Accident (Stroke) Nursing Care and Management: A Study Guide

  https://nurseslabs.com/cerebrovascular-accident-stroke/

  Learn about the nursing care management of patients with cerebrovascular accident in this nursing study guide. […] After the stroke is complete, management focuses on the prompt initiation of rehabilitation for any deficits. […] During the acute phase, a neurologic flow sheet is maintained to provide data about the following important measures of the patients clinical status: Change in level of consciousness or responsiveness. […] Based on the assessment data, the major nursing diagnoses for a patient with stroke may include the following: Impaired physical mobility related to hemiparesis, loss of balance and coordination, spasticity, and brain injury. […] The major nursing care planning goals for the patient and family may include: Improve mobility. […] Nursing care has a significant impact on the patients recovery.

• #9 Nursing Interventions for the Stroke Patient (Powers et al., 2018)

  https://www.nursingcenter.com/clinical-resources/nursing-pocket-cards/assessment-and-management-of-stroke

  In the United States, stroke is the fifth leading cause of death and the leading cause of disability (Centers for Disease Control and Prevention [CDC], 2023). Early identification, evaluation and treatment of stroke reduces motor and cognitive deficits and lowers mortality. Use this nursing pocket card to assist in the identification and treatment of stroke. […] Nursing Interventions for the Stroke Patient (Powers et al., 2018) […] Support airway, breathing, and circulation […] Monitor vital signs at least every 15 minutes initially, as directed by your facility. […] Neurologic assessments should be performed hourly and as needed. […] Treat hyperthermia (temperature greater than 38 degrees Celsius) with antipyretic medications. […] Treat hyperglycemia to keep blood glucose levels between 140-180 mg/dL and treat hypoglycemia (blood glucose less than 60 mg/dL), as directed by your facility.

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