Nurses Crucial to Treating and Preventing Strokes
Posted: August 28, 2014 in Reference Desk
Nurses who are knowledgeable about the causes and treatment of strokes can have a major impact in reducing the number of strokes that occur and reducing the number of people strokes kill and incapacitate.
Cardiovascular disease (CVD) is a leading cause of death in the United States. According to the Centers for Disease Control and Prevention, 800,000 people die each year from cardiovascular disease in the form of heart attacks and strokes.
Strokes occur when blood and oxygen are cut off from the brain, causing damage to or death of brain tissue. Time elapsed before initial treatment is increasingly believed to be crucial to the extent of damage. That damage can be temporary or permanent and can improve to different levels of function with the aid of physical therapy and rehabilitation.
Nurses can facilitate rapid diagnosis and initial intervention such as knowing whether it’s safe to administer aspirin. Their ability to interview and assess hospitalized patients can prevent strokes in that setting, where as many as 17 percent of all strokes occur, according to Stroke.com. Nurses are key advisers during rehabilitation. And they are leaders in prevention, providing information to the public that can lead to lifestyle improvements that reduce the incidence and severity of strokes.
Types of strokes
In medical terms, the word “stroke” is known as a cerebrovascular accident, or CVA. There are two types of strokes: ischemic and hemorrhagic. Ischemic strokes account for 85 percent of strokes. These happen when blood clots or pieces of plaque block a blood vessel and prevent the necessary blood and oxygen to the brain. The less common type, a hemorrhagic stroke, occurs when a blood vessel bursts in or around the brain.
“Mini-strokes” (transient ischemic attacks, or TIAs), also can be significant. They cause no lasting damage but can be a warning sign before a permanent or even fatal larger stroke.
Signs of a stroke: the F.A.S.T. system
The American Heart Association uses the acronym “F.A.S.T.” to help people remember the symptoms and what to do when they occur. F.A.S.T. stands for:
- Face drooping: Drooping or numbness on one side of the face. A person having a stroke will not be able to smile.
- Arm weakness: Weakness, numbness, or the inability to move one arm. May be associated with leg weakness on the same side of the body.
- Speech difficulty: An inability to speak or slurred speech. The person may be unable to repeat a simple sentence.
- Time to call 911: If a person has any of the symptoms above, seek immediate medical attention, even if the symptoms stop.
Emergency stroke treatment consists of diagnosing whether it is ischemic or hemorrhagic. If there is a clot, treatment is focused on trying to dissolve the clot with drugs known as thrombolytics, some of which can be administered by nurses.
Other aspects of stroke treatment depend upon how serious the stroke is and any medical complications that may follow. Rehabilitation in the form of physical therapy, occupational therapy and speech therapy may be necessary for many weeks. This type of intensive rehabilitation is usually provided at an inpatient rehabilitation center. After rehabilitation efforts, treatment consists of actions taken to prevent a second stroke.
Persuading patients to accept treatment is vital. This includes taking medications as prescribed, monitoring of cholesterol levels and blood pressure, and control of diabetes.
Stroke risk factors and prevention
Stroke prevention refers to the efforts taken to prevent a CVD stroke from occurring.
That means an effort to reduce the number of people with hypertension and the number of people who know little about the causes of strokes. Nationwide, according, to the CDC, 67 million people have hypertension, a chronic condition with no symptoms but serious consequences if it is not managed.
Most stroke prevention involves more healthful diets and weight control, encouragement of physical activity, reduction of alcohol consumption and cessation of smoking. Those whose ethnic groups are stroke-prone learn to be concerned about their risk.
According to Stroke.org, stroke center personnel agree that public lack of knowledge about the appropriate response to stroke symptoms is a key barrier to stroke treatment, which makes it all the more important for nurses to have that knowledge to impart.
Public knowledge has been demonstrated to be effective. The New York City Health and Hospitals Corporation, for example, has instituted a drive to help patients lower blood pressure via a “Treat to Target” program, which it says “increases the role of registered nurses and allows for more frequent and focused clinic visits to help patients with hypertension achieve healthier blood pressure levels, which in turn reduces their risk of heart attacks, strokes and kidney disease.” In one year, the HHC reported, about one in six hypertension patients were managing their high blood pressure.
Nurses are increasingly sources of treatment and prevention of strokes. Those who take the time to gain expertise and to discuss CVD stroke prevention with their patients can empower them to take responsibility for their health — and may even help to save lives.
edited by Colin SeymourLearn More: Click to view related resources.
- "Stroke Information," CDC
- "911 Warning Signs of a Heart Attack," Heart.org
- "Thrombolytic Therapy," National Institute of Health
- "Preventing Stroke: Healthy Living Habits," CDC
- Jassin M. Jouria Jr., MD ; Michael Jay Katz, MD, PhD, "Stroke: Acute Treatment," NursingCEU.com
- "Diagnosis and initial treatment of ischemic stroke," National Guideline Clearinghouse, Agency for Healthcare Research and Quality
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