Response one : The patient can present with extremity weakness, loss of coordination, slurred speech, one-sided facial drupe, numbness, confusion, trouble speaking, or difficulty understanding others, trouble seeing in one or both eyes, trouble walking, dizziness, loss of balance, or lack of coordination, severe headache with no known cause. Some or all of these symptoms can present at the time of the CVA. Even sensory inputs like sharp, dull, soft, hard, pain, heat, cold, etc.….
This is the time when a family’s emotional, financial and spiritual support can make or break a well thought out plan. Family members must step up and help in any way they can. This can cause great conflict not only among the family members but also within the patient. For example, if the patient was the sole financial support for the family; feelings of guilt, anxiety, and depression can occur for not just the patient but the supported family members. Family member dynamic roles will shift; some willing others by default. As a nurse for this patient your role will change as the person stages of grief are worked through. You may be simply an ear to listen, a voice of reason, a provider of resources or even a cheerleader but you will always be a patient advocate.
Response two : According to the American Stroke Association stroke is a disease that affects the arteries leading to and within the brain. It is the No. 5 cause of death and a leading cause of disability in the United States.
A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts. When that happens, part of the brain cannot get the blood/ oxygen it needs, so it and brain cells die (About Stroke, n.d.).
The effects of a stroke can be devastating. The brain is an extremely complex organ that controls various body functions. If a stroke occurs and blood flow can’t reach the region that controls a specific body function, that part of the body won’t work as it should. (About Stroke, n.d.)
Common psychological difficulties include anxiety, depression, grief, frustration, reduced emotional control and anger (Stroke Association, 2008).
There are several things you can do for stroke prevention such as monitor your blood pressure, control your cholesterol, keep your blood sugar down, exercise, eat health, lose weight if your obese, don’t smoke-quit if you do, and talk to your doctor about medication therapy.
The role of the nurse may be different depending on where you work and at what stage you receive the patient, i.e. post stroke, ER, etc. However, the basic care includes NIHSS evaluation and neuro checks, explaining to patient and families what is happening, therapy/treatment plan, what tests will be done and where they go from here (About Stroke, n.d.).
Targeted treatment includes aspirin therapy if no bleed on CT, blood pressure/vital monitoring continuously, temperature monitoring, oral hygiene, mobilization, and Serial ECG’s. The nurses also are involved in initiating referrals to the appropriate stroke services for patients and families.