This video covers stroke and cerebrovascular accident (CVA). The pathophysiology, risk factors, signs/symptoms (including left vs. Right-sided stroke symptoms), diagnosis, treatment of a stroke. Nursing care for a patient with a stroke.
Our Medical-Surgical video tutorial series is taught by Cathy Parkes BSN, RN, CWCN, PHN and intended to help RN and PN nursing students study for their nursing school exams, including the ATI, HESI and NCLEX.
0:00 What to Expect with a stroke (CVA) 0:25 Stroke (CVA) 0:40 Hemorrhagic/ Ischemic 0:53 Thrombotic/ Embolic 1:14 Risk Factors of Stroke (CVA) 1:43 Signs and Symptoms of Stroke (CVA) 2:14 Memory Trick 3:01 Memory Trick 3:23 Diagnosis of Stroke (CVA) 3:33 Treatment of Stroke (CVA) 4:09 Nursing Care 5:12 Quiz Time!
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Content
0.32 -> Hi, I'm Cathy with LevelUpRN. In this video,
we are going to talk about a stroke or
5.36 -> cerebrovascular accident. At the end of the video,
I'm going to give you guys a little quiz, a little
11.04 -> knowledge check to test your understanding of some
of the key points I'll be making in this video. So
16.72 -> definitely stay tuned for that. And as always, if
you have our medical surgical nursing flashcards
22.32 -> definitely pull those out so you can
follow along with me. With a stroke,
26.4 -> we have the sudden interruption of blood flow
to the brain and this deprives the brain of
32.4 -> the oxygen and the nutrients that it needs. And
this leads to brain tissue damage and necrosis.
39.52 -> So we have hemorrhagic strokes and ischemic
strokes. With a hemorrhagic stroke, we have a
46.8 -> ruptured artery or aneurysm in the brain.
Ischemic strokes are caused by a blood clot.
53.44 -> So we have a thrombotic stroke, which is where
we have a blood clot in the cerebral artery,
59.76 -> or we have an embolic stroke, which is where
a blood clot from another part of the body
66 -> travels up and blocks the cerebral artery. So
this could be caused by a DVT, for example.
73.68 -> Risk factors associated with a stroke
include smoking, hypertension, diabetes,
80.8 -> A-fib, hyperlipidemia, and a previous TIA, which
is a transient ischemic attack. So with a TIA,
91.28 -> there is the temporary blockage of blood flow
to the brain, and if a patient has had a TIA,
98.24 -> it places them at much higher risk
for having a stroke in the future.
103.36 -> Symptoms of a stroke include unilateral
limb weakness. So sudden weakness of the
108.56 -> arm or leg on one side. It can also cause
facial drooping, slurred speech, dizziness,
115.76 -> as well as visual disturbances. If the patient
has a stroke on the left side of the brain,
122.24 -> that can cause something called expressive
aphasia. This means that the patient will have the
127.52 -> inability to speak or understand language. They
may also have difficulty with reading and writing.
134.4 -> So our little cool chicken hint here on the card
is left equals language. So if you have a stroke
140.8 -> on the left side, that can definitely impact
the patient's language abilities. In addition,
147.44 -> if the patient had that stroke on the left side,
that can cause right-sided weakness or paralysis.
154.4 -> So if you watched my AMP review of the nervous
system, you know that the left side of the brain
159.52 -> controls movement on the right side of the
body. So that's why with a left-sided stroke,
164.4 -> we have that paralysis or weakness on the right
side of the body. If the patient had a stroke on
171.04 -> the right side of the brain, that can cause poor
judgment and impulse control, it can cause the
177.92 -> patient to overestimate their abilities as well.
So our little cool chicken hint here is that right
185.44 -> equals reckless, which means that the patient will
have poor judgment if they have that right-sided
191.68 -> stroke. In addition, with a right-sided stroke,
we are going to have left- sided weakness or
199.04 -> paralysis because the right side of the brain
controls movement on the left side of the body.
204.96 -> Diagnosis of a stroke includes the use
of a CT, an MRI, or a cerebral angiogram.
212.32 -> In terms of treatment, if the patient had an
ischemic stroke, then we could use thrombolytic
217.92 -> agents such as Alteplase. However, we want
to make sure we administer these thrombolytic
223.68 -> agents within three hours of the onset of
symptoms, and that's important to remember.
229.52 -> Other medications for an ischemia stroke
include anticoagulants as well as antiplatelets.
236.08 -> If the patient had a hemorrhagic
stroke, then we would administer
240.5 -> antihypertensive agents to try to bring that blood
pressure down and prevent any more blood loss or
247.36 -> minimize blood loss, at least. In terms of nursing
care, we're going to want to implement fall
252.64 -> precautions because the patient will likely have
paralysis or paralysis on one side of their body.
258.96 -> We want to assess their swallowing ability
and their gag reflex before letting them
264.32 -> eat or drink anything. So if the patient has
dysphagia, they may require thickened liquids.
271.28 -> And if they have dysphagia, we want to advise
them to chuck-- tuck not chuck. Tuck their chin
277.6 -> against their chest to help facilitate swallowing.
We also need to reposition our patients frequently
284.8 -> in order to prevent pressure injuries. And then
if our patient has something called homonymous
290.88 -> hemianopsia, which means that they only
see on one side of their visual field,
298.16 -> then we need to advise them to use what's
called a scanning technique. So they would need
303.52 -> to scan the whole visual field in order to see
everything, because if they don't scan, they're
309.44 -> just seeing one side of that visual field.
All right. Time for a quiz. I have three
315.44 -> questions. First question, a temporary blockage
of blood flow to the brain is called a blank.
325.2 -> The answer is a TIA or transient
ischemic attack. Question number two,
332.32 -> a stroke on the left side of the brain can
cause expressive aphasia. True or false?
341.6 -> The answer is true. So remember, left side
language. Okay, question number three,
348.72 -> for an ischemic stroke, thrombolytics should
be administered within blank hours of symptoms.
358.24 -> The answer is three. So they need to be
administered within three hours of symptoms.
363.52 -> Okay, that's it. I hope you enjoyed
this video and I hope it was helpful.
368.08 -> If so, make sure to like it and
leave me a comment. Take care.
