NSG 326 Adult Health IStrokeSlide 3StrokeWorldwide Stroke FactsGENERAL STROKE FACTS in USAStroke & the World’s WomenStroke & Black AmericansSTROKE in LAST 10 YEARSNC STROKE FACTSNC STROKE FACTSSlide 12AMERICA’S WOMEN & STROKE FACTSWomen & Stroke FactsSTROKE RECOGNITIONTHE PUBLIC & STROKERURAL AREAS & STROKESlide 18Slide 19Types of StrokeMajor Types of StrokeIschemic StrokeIschemic StrokeSlide 24Slide 25Sites for AtherosclerosisSlide 27Slide 28Slide 29Hemorrhagic StrokeSlide 31Slide 32STROKE: Usual Signs & SymptomsSlide 34WOMEN: Stroke Symptoms“Mini-Stroke” or TIASlide 37Manifestations of Right-Brain and Left-Brain StrokeStroke - Clinical ManifestationsStroke - Clinical ManifestationsSlide 41Slide 42Slide 43Stroke –Clinical ManifestationsSlide 45Slide 46Slide 47Slide 48Slide 49Slide 50Diagnostic StudiesSlide 52Stroke Acute CareStroke AssessmentNursing InterventionsInterventions (cont.)Carotid EndarterectomyBrain StentRisk Factors NonmodifiableRisk Factors ModifiableStroke PreventionStroke Prevention (cont.)Stroke PreventionStroke RehabilitationStroke – Nursing DiagnosesStroke – Nursing GoalsPost Stroke - RisksSlide 68Slide 69Post Stroke - Nursing ManagementSlide 71Slide 72Slide 73Slide 74Assistive Devices for EatingSlide 76Slide 77Homonymous Hemianopsia (Food on left side is not seen)Slide 79Slide 80Slide 81Slide 82Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved.Created &/or Adapted by Dr. K. A. EnnenNSG 326 Adult Health INSG 326 Adult Health IWeek #13 Week #13 Spring 2011Spring 2011StrokeStrokeCopyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved.2StrokeStroke•An abrupt or rapid onset of a An abrupt or rapid onset of a neurological deficit resulting from neurological deficit resulting from disease of the blood vessels that supply disease of the blood vessels that supply the brain.the brain.•Stroke occurs when there is ischemia to Stroke occurs when there is ischemia to a part of the brain that results in death a part of the brain that results in death of brain cellsof brain cells•Also known as brain attack & CVAAlso known as brain attack & CVACopyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved.4Stroke Stroke •Functions are lost or impairedFunctions are lost or impairedSuch as movement, sensation, or emotions Such as movement, sensation, or emotions that were controlled by the affected area that were controlled by the affected area of the brain of the brain •Severity of the loss of function varies Severity of the loss of function varies according to the location and extent of according to the location and extent of the brain involved the brain involvedWorldwide Stroke Worldwide Stroke FactsFacts•Worldwide stroke is the second leading Worldwide stroke is the second leading cause of death and the leading cause of cause of death and the leading cause of disability disability (WHO, 2004).(WHO, 2004).•15 million people suffer stroke 15 million people suffer stroke worldwide each year. worldwide each year.  5 million die and another 5 million are 5 million die and another 5 million are permanently disabled.permanently disabled.Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved.6 GENERAL STROKE FACTS in USAGENERAL STROKE FACTS in USA•795,000 new or recurrent 795,000 new or recurrent strokes in 2009strokes in 2009•On average someone has a On average someone has a stroke every 40 secondsstroke every 40 seconds•Strokes account for 1 of Strokes account for 1 of every 18 deaths & ranks every 18 deaths & ranks third in cause of all deathsthird in cause of all deathsCopyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved.7Stroke & the Stroke & the World’s WomenWorld’s Women•Women experience over half of Women experience over half of all strokes, 60% of stroke-all strokes, 60% of stroke-related deaths, and a death rate related deaths, and a death rate of 11% versus 8.4% for men. of 11% versus 8.4% for men. •Heart disease & stroke kill more Heart disease & stroke kill more women worldwide than cancer, women worldwide than cancer, HIV/AIDS, malaria, and TB HIV/AIDS, malaria, and TB combined. combined.Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved.8Stroke & Black AmericansStroke & Black Americans•Blacks have twice the Blacks have twice the risk of first-ever stroke risk of first-ever stroke compared to whitescompared to whites•Stroke occurrence in Stroke occurrence in Americans 45-84 years: Americans 45-84 years:  6.6 per 1000 in black 6.6 per 1000 in black males (3.6 in white) males (3.6 in white)  4.9 per 1000 in black 4.9 per 1000 in black females (2.3 in white)females (2.3 in white)Copyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved.9STROKE in LAST 10 YEARSSTROKE in LAST 10 YEARS•Despite the fact that from 1995 to 2005 the stroke death Despite the fact that from 1995 to 2005 the stroke death rate fell 29.7%, and the actual number of stroke deaths rate fell 29.7%, and the actual number of stroke deaths declined 13.5%, stroke continues to be the third leading declined 13.5%, stroke continues to be the third leading cause of death in the United States making stroke cause of death in the United States making stroke knowledge and recognition an important public health knowledge and recognition an important public health concern concern •Leading cause of serious, long-term disabilityLeading cause of serious, long-term disability•Approximately 25% of individuals who have an initial Approximately 25% of individuals who have an initial stroke die within 1 yearstroke die within 1 yearCopyright © 2007, 2004, 2000, Mosby, Inc., an affiliate of Elsevier Inc. All Rights Reserved.10NC STROKE FACTSNC STROKE FACTS•Stroke is 3Stroke is 3rdrd leading cause of leading cause of death in NCdeath in NC•In 2006, stroke caused 4,551 In 2006, stroke caused 4,551 deaths, 6.1% of all deaths deaths, 6.1% of all deaths that yearthat year•Stroke is 5Stroke is 5thth leading cause of leading cause of years lost life, ~ 22,335 years years lost life, ~ 22,335 years of life lost in 2005of life lost in 2005•NC’s age-adjusted stroke NC’s age-adjusted stroke death rate is the 5death rate is the 5thth highest highest among 50 statesamong 50