Drug And Secondary Prevention Of Stroke And Transient Ischaemic Attack

The patient should avoid illegal drugs. Illegal drugs can cause more pressure on the blood vessels and thus causing the blood vessel to burst. This will cause the blood to leak into the brain. Illegal drugs can also cut off blood flow to the brain, causing an ischemic stroke. Another way to reduce stroke risks is by maintaining a healthy diet. This will lower the levels of cholesterol in the blood and decrease the blood pressure. In return the blood vessels will not become blocked or burst due to the constricted blood vessel walls. To go with the healthy diet the patient should exercise regularly. If the patient is able to exercise five days a week, the risk of a stroke would be vastly reduced. In a case where the patient has diabetes, they need to keep it under control. According to webmd people with diabetes are at a two-and-half times higher risk of a stroke than those without. Patients need to control the amount of alcohol consumed and quit smoking if the patient smokes. If the patient drinks a lot of alcohol it will increase the body’s blood pressure. With an increased blood pressure the blood vessel walls can bust. When someone smokes, their blood vessels are more likely to have a blood clot thus causing a stroke. If the patient has any sleep apnea problems they should get them treated. A study by the American Academy of Sleep Medicine has found that people with

Mariam background is 60 year old lady admitted with left sided weakness and facial droop. Once confirmed stroke using the Recognition of Stroke in the Emergency Room (ROSIER) scale. Catangui (2015) states ROSIER scale is used to distinguish whether the patient is having a stroke or stroke mimics e.g. seizures or brain tumours. Computed tomography CT brain showed ischemic stroke. Ischaemic stroke is lack of sufficient blood supply to perfuse the brain/ cerebral tissue due to narrowing or blocked arteries in the brain (Morrison, 2014). According to Stroke Association (2015) statics shows that 1520000 strokes occur in the United Kingdom.

The health issue that this artifact discusses is the significance of knowing and recognizing the warning signs of a stroke. The American Heart Association has made it their mission to provide unlimited health information and research in the hopes of eliminating cardiovascular diseases as well as helping society in maintaining a healthy lifestyle. “Stroke is the number 5 cause of death and a leading cause of

It is important that the type of stroke is diagnosed quickly to reduce the damage done to the brain and also to determine the right type of treatment because one treatment for one kind of stroke can be harmful to someone who has had a different kind. A number of different medications may be given at the hospital to help break up the clot and prevent the formation of new clots. For Ischemic stroke the treatment can begin with drugs to break down clots and prevent further ones from forming. Aspirin can be given, along with an injection of a tissue plasminogen activator (TPA). TPA works by dissolving clots but it needs to be injected within 4.5 hours of stroke symptoms once they have presented themselves. Hemorrhagic stroke treatment can begin with drugs being given to reduce the pressure in the brain, overall blood pressure, prevent seizures and prevent sudden constrictions of blood vessels.(http://www.mayoclinic.org/diseases-conditions/stroke/diagnosis-treatment/treatment/txc-20117296) Because strokes are life-changing events that can affect a person both physically and emotionally, temporarily or permanently. After a stroke,

This tool is applied to the assigned CPG "Clinical guidelines for stroke management 2010" in relation to the management, diagnosis and treatment of stroke. Stroke occurs when there are blood clots

Stroke is noted by Lee, Shafe and Cowie (2011) to be a major cause of both morbidity and mortality in the United Kingdom. It is estimated that close to 110,000 incidences of stroke occur in England annually (National Audit Office,2004) with recent studies reporting that the rate of incidence ranges between 1.36/1000 per year (Hippisley-Cox , Pringle , Ryan, 2004) and 1.62/100 per year between 2002 and 2004 (Rothwell et al,2004). Even though cases of deaths from stroke has decreased in the United Kingdom over the last forty years, stoke accounted to close to 46500 deaths in Wales and England in 2008 (accounted for 9 percent of all death cases (Lawlor et al,2002; Office for National Statistics,2008). The current United Kingdom health policy places a lot of emphasis on the reduction of stroke (Department of Health,2007,2008). Key to realizing this is the importance and need for better management of the vascular risk factors such as hypertension, high cholesterol, obesity, diabetes and atrial fibrillation. In this paper, we present an essay based on the assessment of care of an elderly patient suffering from six different pathologies with stroke (non-haemorrhagic) being our pathology of choice. A rationale for this choice is provided followed with the underlying pathophysiology of the chosen aspect of care and finally an evidenced based analysis of the nursing interventions required for the selected aspect of care.

Porter 2015, mentions any individual can reduce the risk of stroke by eating healthy, have a low salt intake, exercise regularly, keep a healthy weight, avoid tobacco products and drugs, monitor alcohol intake, properly use medication if provided, and stay informed about your health issues.

Although Statin family of drugs were not primarily designed to be protective against ischemic stroke there is significant evidence in randomized studies that it lowers the incidence of cerebrovascular events (doc3.pdf-table1)

The article emphasizes time as a critical aspect to acute ischemic stroke management. The leading method of treatment in AIS is intravenous rtPA because the door-to-needle time is less compared to the time it takes to do methods that use thrombectomy devices or catheterization. I believe that it is vital for people to know the signs and symptoms of acute ischemic stroke because it is one of the leading causes of death and disability. The faster one is able to identify these signs and symptoms, the better an outcome it would be for both the patient and their family members. The general public and hospital staff members should be educated on AIS. This article also briefly touches on the fact that patients suspected of having a more severe stroke (proximal artery occlusion) should be immediately transported to a

Less than an hour after arrival, the consulting vascular and interventional neurologist connected to the telestroke cart and controlled the camera to see the patient in real time. The patient and family were able to view the specialist on the screen in front of them and were able to carry on a conversation similar to a video chat but with higher resolution cameras. The neurologist completed the National Institute of Health Stroke Scale (NIHSS) and answered questions from the patient, spouse, emergency nurse, and physician. The specialist and emergency physician discussed the plan of care with the patient and spouse and ordered tPA after obtaining consent from the patient. The neurologist remained connected during initiation of tPA allowing the bedside nurses to ask questions in real time regarding blood pressure management. (The patient’s manual systolic blood pressure was 185 mm Hg, which was at the upper limits of the CAH facility’s policy for administering tPA.) The specialist gave the order to continue with the tPA along with parameters to treat the blood pressure if needed. The patient’s systolic blood pressure did not exceed 185 mm Hg; therefore, no additional treatment was required.

I should have educated about healthy diet and daily 30 minutes of aerobic exercises. I should have encouraged to increase fruits, vegetables, reduce salt intake, low fat/cholesterol diet, serving sizes and avoiding canned and fast food. Also, I should have educated about maintaining proper intake of dietary potassium, calcium and magnesium (Madhur, 2014). I should have educated about the increase bBP with decongestants. Regular aerobic exercises can be walking, using bicycles and climbing stairs. Effectiveness of lowering BP increases when diet and lifestyle modification are combined together (Cash, 2015). Also, I should have mentioned about not exceeding 2 drinks of alcohol per day and smoking cessation (Weber et al., 2014). This is because most of the patient with high BP have other cardiovascular risk factors such as diabetes, hyperlipidemia, tobacco use and inactivity. Hence, while treating HTN, we must address all these risk factors and take preventive measures (Dunphy et al., 2015). I should have educated on relaxation techniques and lowering stress level (Cash, 2015). Diuretics, ARB, ACE and calcium channel blocker are the first line therapy for the HTN (Hernandez-Vila,

Hypertension is an indication of an increased risk for stroke. According to Verdecchia et al. (2015), there is a linear relationship between hypertension and increased stroke risk. The risk of stroke can be reduced with a decrease in systolic and diastolic blood pressure readings. In patients with a previous history of coronary artery disease, the ideal blood pressure is a baseline of 118/68 mmHg and a systolic of less than 140 mmHg (Verdecchia et al., 2015). Because of the evidence that associates hypertension with stroke risk, we offered and performed blood pressure screenings to the general public for our community intervention.

The stroke is a condition with an abrupt onset of a neurological deficit that attributable to a focal vascular cause. (1) It is the third leading cause of death worldwide. (2) Lower-income countries have shown a higher relative stroke burden compared to industrialized ones. (3) Despite the significant achievement in management of acute stroke, it remains also a third cause of death in industrialized countries.(4) Over a third of stroke deaths occur in developing countries(5) In the United States,700000 stroke cases responsible for 165000 deaths each year (6). The number of people having a stroke each year in Iraq is around 24000. (7) Determining predictor of mortality at period of hospitalization could aid a clinical care by providing valuable prognostic information to patients and their family members and identify those at high risk for poor outcomes who may require more intensive recourses. Various clinical variables have been implicated in the etiology of in hospital mortality of stroke. This study is an attempt to evaluate the effect of a number of these variables and whether they could predict in hospital mortality or not. These predictors included important co- morbidities like diabetes mellitus ( DM), ischemic heart diseases(IHD) hypertension( HTN) , and role of diastolic blood pressure (DBP) in first few hours after attack , history of old stroke and medications that expected to change the outcome of

The aim of this review was to determine the effects of anti-hypertensive drugs in patients with HTN and symptomatic PAD in terms of cardiovascular events and the effect on the ankle brachial index (ABI) to measuring outcomes (Lip and Lane, 2013). A randomized controlled trial with 3610 PAD patients was used to study the effects of anti-hypertensive drug treatment plan that included an ACE inhibitor and Neb. The parameters of the study were measured using the ABI and claudication walking distance and descriptive statistics were used. Overall, there was no significant decrease in non- fatal myocardial infarction or non-fatal stroke with or without revascularization (OR.9, 95% CI.76 to 1.07 and OR.96, 95% CI.82 to 1.13) (Lip & Lane, 2013). There was no significant change in the ABI of the trials either. While the data was not solidly conclusive, patients did receive the benefits of having lower BP from both of these drugs (Lip & Lane,

Ischemic stroke prevalence is restricted by both incidence and circumstance fatality the higher the incidence, the greater the prevalence and, conversely, the lower the prevalence. Little information on stroke prevalence is available because leading prevalence studies is difficult from a methodological point of view. The age standardized prevalence for people old 65 years has been estimated to range since 36 to 73/1000 person per years in the insufficient published population created studies available. In 2010, universal estimations showed 33 million prevalent cases of stroke, corresponding to a global prevalence rate of 5/1000 person per years (0.36/1000 person-years in those aged greater than 75 years, and 48.4/1000 person per years in those