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Copyright © 2022 Wild Iris Medical Education, Inc. All Rights Reserved.

BY: 

Judith Swan, MSN, BSN, ADN; Michael Jay Katz, MD, PhD

LEARNING OUTCOME AND OBJECTIVES:  Upon completion of this continuing education course, you will demonstrate an understanding of the anatomical alterations, pathophysiology, diagnosis, evaluation, and treatment options, emphasizing acute care and initial rehabilitation, for patients who have experienced a stroke. Specific learning objectives to address potential knowledge gaps include:

  • Review stroke epidemiology.
  • Identify risk factors, triggers, and effects of stroke.
  • Discuss major classifications, including pathophysiology and clinical presentation.
  • Describe the components of prehospital and emergency department evaluation and management.
  • Discuss the guidelines for early treatment and management of patients with acute stroke.
  • Identify the complications and associated interventions that may occur during the intensive care unit (ICU) care of acute stroke patients.
  • Summarize hospital nursing management for stroke patients beyond 24 hours.
  • Identify assessment, interventions, and goals of physical, occupational, and speech-language stroke rehabilitation in the acute setting.
  • List actions to be taken in the prevention of secondary stroke.

TABLE OF CONTENTS

  • Introduction
  • Epidemiology
  • What Is a Stroke?
  • Types of Stroke
  • Prehospital Management of Acute Stroke
  • Emergency Department Stroke Evaluation and Management
  • Early Treatment and Acute Stroke Management
  • Preventing and Managing Complications Post 24 Hours
  • Nursing Care Beyond 24 Hours
  • Rehabilitation in the Acute Stroke Setting
  • Discharge from the Hospital
  • Conclusion
  • Resources
  • References

INTRODUCTION


A stroke—also called a cerebrovascular accident (CVA) or a brain attack—is a reduction or interruption of the flow of blood through an artery to one or more areas of the brain within the territory supplied by that artery. The end result is varying degrees of neurologic and/or cognitive malfunction lasting longer than 24 hours. A very severe stroke can cause sudden death.

Stroke is a medical emergency, and for persons experiencing a stroke, the difference between recovery and disability or death is measured in hours. For healthcare professionals, it is imperative that an understanding of stroke and the ways to take action become part of day-to-day practice. Providers are responsible for improving their skills along the continuum of care from prehospital/acute stroke to poststroke education. In addition, educating patients about stroke prevention and recognition of stroke should be part of every provider’s practice.