Stroke Risk Factors - Essay Example

? Nursing Table of contents Nursing 1 PART I 2 PART II 2 Causes of stroke 3 STROKE RISKFACTORS 4 Symptoms 4 Treatment 5 TREATMENT IN THE HOSPITAL 5 LONG-TERM TREATMENT 6 Prognosis 6 Possible Complications 7 Reference: 7 PART I These are my clinical questions formulated after reading and following the format of patient’s problem or his/her population, intervention, comparison and outcome .commonly known as PICO format (Sackett, et al 1997). i. This case involves a lady of sixty eight years age suffering from stroke. ii. On my intervention I considered the ECG conducted on arrival. iii. My comparison intervention is on the necessities of performing the ECG test conducted to the patient on arrival or not conducting. iv. The outcome of the intervention is for better diagnosis which helps to set the appropriate treatment for the patient. The question that makes need of my research is whether performing of ECG test on patient arrival helps in better diagnosis compared to delayed ECG test on stroke’s patients ? PART II The method of searching online has been used as a resource for information. These are research healthcare databases such as Medline plus, U.S National Library of medicine. The reason to use this database is that it is a nursing database that you can search online and offer usually access a greater scope of information. The most nursing research and articles as well as journal are found mainly on this database. Medline plus is also a free access to the public. This provides a tool for nursing in finding the resources a given case study as it is in my research. I made my search on electronic databases as well as catalogues in finding the information that was to link the case study of ECG test on stroke and also give the appropriate information. I made use of a key word that was typed on Google search. The basic search method that was followed are; identifying the key concept to be searched, entering keyword into the Google search box , clicking on search then an appropriate database was evaluated based on information presented and the level of trust to the source of this information. On evaluation after comparison with other sources such as The Alan E. Lindsay, ECG Learning center in cyber space but felt Medline plus had more accurate information which met my search demand. Other sources that were identified and downloaded on this ECG test but gave sketchy information on it and hence Medline plus was taken as the best. PART III A stroke usually happens if the blood flow stops to some part of the brain. Causes of stroke When blood flow get stopped for long as few seconds and the brain does not get blood which carries with it oxygen then it can cause the cells to die and this causes a permanent damage. Usually there are two types of stroke that are major. They include; ischemic and also hemorrhagic stroke. Ischemic stroke occurs at the time when blood vessel supplying blood to the brain gets blocked by a clot in blood. This usually happens in two ways: A clot forms in the artery which is very narrow (thrombotic stroke),a clot breaks off right from any place of blood vessels that are in the brain or from other parts of the body and then travels to the brain(cerebral embolism or the embolic stroke). Ischemic strokes can be caused by clogging of arteries. Some Fat and cholesterol usually collect on the walls of arteries and forms sticky substance known as plaque. Hemorrhagic stroke usually occurs if the blood vessel on brain part is weak and bursts thereby causes blood leak to the brain. Some people may have defects that are in blood vessels and in the brain making this likely to happen (Latchaw 2009). STROKE RISK FACTORS High blood pressure is a high risk for strokes followed by the others such as; Atrial fibrillation, Diabetes, Family history on stroke, High cholesterol, age(especially in age 55 and above) and race such as black people who are more prone to dying of a stroke. People with heart disease and also poor blood flow from their legs caused by arteries that are narrow may likely get stroke. The stroke chances are higher to people with unhealthy lifestyle; being overweight or being obese, drinking heavily, eating much fat and salt, smoking and taking cocaine as well as other illegal drugs. Control pills for birth increases the possibility of blood clots hence high risk of stroke. Risk is high to a woman that smoke and has 35 years and above. Symptoms The signs of stroke may depend on part of brain that is damaged. Symptoms develop suddenly with no warning. In Some cases symptoms occurs on and off in the first day and in some cases two. Symptoms are very severe first at time when stroke happens and may it get worse. A headache usually occurs mostly if the bleeding in the brain is the cause of the stroke. The headache; Starts suddenly as well as becomes be severe, occurs on lying flat, makes you wake up from sleep, gets worse on changing positions. Various symptoms may depend on severity of stroke and the part to the brain that is affected. These symptoms include; Lack of control to the bladder Balance loss Coordination loss Muscle weakness at the face or arm and leg. This is usually on one side. Changes in alertness Change in hearing Change in taste Changes affecting touch as well as ability in feeling pain and temperatures Clumsiness loss of memory Difficulty in swallowing Difficulty in writing or reading Dizziness Numbness and tingling usually on one side in the body Emotional changes Eyesight problems such as decreased vision or total loss in vision Trouble in speaking and understanding other’s speaking Trouble walking A complete exam and test should be done by the doctor; i. Check for the problems on vision, feeling, understanding, speaking, movements and reflexes. This is done continuously so as to see whether the condition is improving. ii. Listening to an abnormal sound (bruit) using the stethoscope in listen the carotid (arteries) in the neck. This is caused by blood flowing abnormally. iii. Check the blood pressure. Tests that helps the doctor in finding the location and cause as well as type of the stroke; Angiogram on the head shows the blood vessel that is blocked or even bleeding, carotid duplex (which is ultrasound) to show carotid arteries that have narrowed, CT scan for the brain done when symptoms begins, Echocardiogram when stroke is caused by the blood clot and magnetic resonance angiography for checking on abnormal blood vessels that are in the brain (Latchaw 2009). Treatment A stroke requires a medical emergency and immediate treatment saves live and can reduce disability. It is important to people having stroke symptoms get into a hospital quickly so as to get catered for. When stroke get caused by the blood clot then clot busting drug is administered to dissolve this blood clot. Most of patients that reach hospital within three hours right from the time symptoms begin get to receive these drugs. Some people receive these drugs 4 - 5 hours after beginning of the symptoms. TREATMENT IN THE HOSPITAL Thrombolytic therapy involves clot bursting and is used when stroke cause is blood clot. These breaks up the blood clots and bring back flow of the blood on the damaged part. However, not this medicine is not given to everyone; for them to work this person must be treated within 3 hours from symptoms start. A CT scan should be done to see if stroke is due to a clot or the bleeding. When stroke cause is bleeding then clot busting drugs usually causes more bleeding hence should not be given (Latchaw 2009). Other treatment that may depend on the stroke cause includes: Blood thinners; heparin can be used in treating strokes that are because of blood clots. E.g. Aspirin, clopidogrel. Others drugs that control blood pressure. Surgery on carotid artery may sometime be needed. Nutrients and fluids are needed when a person is in trouble when swallowing and are given through vein i.e. intravenously or by the tube to the stomach. LONG-TERM TREATMENT The goal of treating stroke is helping a patient to recover and function and avoid future strokes. The time to recover and treatment vary for each person. A problem in moving and thinking as well as talking improves from weeks to months. Some people with stroke keep on improving from months to years. Prognosis The prognosis depends on; the type stroke one is suffering from, by how much the brain tissue has been damaged, the body functions affected and by how fast one gets treated. One may recover completely or may have permanent loss of function. More than half of people suffering from stroke functions well and live at their home while other people may not be able to function or work by themselves. Sometimes the treatment by use of clot busting drugs become successful and this symptom of stroke sometimes may go away. However, a patient does not go to the hospital sooner enough in order to be given these drugs or take these drugs due to health conditions. Those people with a stroke because of blood clot, ischemic stroke usually have better chance for surviving than those with a stroke caused by bleeding at their brain, hemorrhagic stroke. The risk on a second stroke is greater during the following weeks and months after stroke for the first time and then this risk may begin to decrease. Possible Complications These include; food may be breathed into the airway during aspiration, dementia, falls, loss of mobility, loss of movement, muscle spasticity, poor nutrition. Pressure sores, problems speaking as well as understanding and problems of thinking or getting focusing (Latchaw 2009). In relation to Mrs. Middleton’s ECG test done on stroke on arrival in the emergency department, results shown the presence of Atrial fibrillation. Which is a stroke risk factor based on the research done? It has been proved that this ECG test performed lead to a better diagnosis. Reference: Sackett, D.L., Richardson, W.S., Rosenberg, W., and Haynes R.B. (1997). Evidence based medicine: How to practice and teach EBM. Churchill Livingston. New York. Latchaw R.E, Alberts M.J, Lev MH, Connors JJ, Harbaugh RE,and Higashida R.T. (2009). Recommendations for imaging of acute ischemic stroke: a scientific statement from the American Heart Association. Read More