I have copied and pasted two of my peers discussion post that require responses.
PEER 1:
Stroke is a leading cause of death worldwide and is the third leading cause of permanent disability (Babkair et al., 2023). It is important that we as nurses are able to recognize the signs of stroke and treat accordingly. The general consensus among healthcare professionals is that in stroke patients “time is brain” (Babkair et al., 2023). This is due to the fact that the quicker stroke signs are recognized, and the appropriate treatment is given, then the more brain damage is minimized. The NIHSS scale is one of the more widely used stroke assessment tools. Performance of the NIHSS on patients who present with certain symptoms allows nurses to quickly identify stroke patients, and then escalate this information to the attending physician. According to the U.S. Department of Health and Human Services, the NIHSS is an assessment tool that walks the nurse through a list of questions to ask and tasks for the patient to perform (2024). The nurse should be performing a NIHSS on any patient who has new onset symptoms of speech difficulty, motor deficits, facial palsy, or any other abnormal neurologic activity.
Nurses spend much more time with patients than the physician, and it’s for this reason that we must educate the patient. The nurse should remind the higher risk populations that risk factors for stroke include smoking, hypertension, use of birth control and estrogen containing drugs, and those with family members who have had strokes. Prevention is key with strokes, but sometimes strokes still happen. This is why prompt recognition of the signs, quickly notifying the physician, treating stroke victims per protocol, and monitoring closely afterwards for deficits are some key points that all nurses should know when dealing with stroke patients.
References
Babkair, L. A., Safhi, R. A., Balshram, R., Safhei, R., Almahamdy, A., Hakami, F. H., Alsaleh, A. M., Martínez-Sabater, A., Chover-Sierra, E., & Saus-Ortega, C. (2023). Nursing Care for Stroke Patients: Current Practice and Future Needs. Nursing Reports, 13(3), 1236–1250. https://doi.org/10.3390/nursrep13030106
U.S. Department of Health and Human Services. (2024, February 8). NIH stroke scale. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/health-information/public-education/know-stroke/health-professionals/nih-stroke-scale
PEER 2:
The neurological assessment is a guide for the nurse to use to determine if a patient has any neurological dysfunction or deficits. When a patient presents with altered level of consciousness and/or neuro deficits, a possible stroke should come to that nurse’s mind. A neuro assessment would then be performed to determine the patients baseline on admission or rule out other diseases that could mimic a stroke. The nurse will use the NIHSS to score the patient on their stroke symptoms. This exam focuses on level of consciousness, visual and motor function, sensation and neglect, cerebellar function, and language capabilities.
When dealing with a possible stroke patient, it is often said “time is brain”, meaning time is the most crucial aspect in potentially preventing irreversible brain damage. It is important to know when the last known well time of the patient is to help determine how long the patient has been without oxygen to their brain and if thrombolytic therapy could be used. This time can be determined by asking family members when they last saw or spoke to the patient. When the patient presents with stroke symptoms it is best practice to get a head CT within one hour of onset of symptoms.
One of the main roles of the nurse in stroke prevention is education. The most common risk factors are hypertension, diabetes, and smoking. These patients should also be educated on early signs and symptoms of stroke. Some early signs would include change in level of consciousness, slurred speech, and facial dropping. The nurse should educate on health promotion such as healthy eating, quitting smoking, exercise, controlling blood pressure, blood sugar and hyperlipidemia. Eating a healthy diet and exercising could significantly decrease their risk of stroke.
References
Updated guidance confirms crucial role of nurses for patients with acute ischemic stroke. American Heart Association. (2021, March 11). https://newsroom.heart.org/news/updated-guidance-confirms-crucial-role-of-nurses-for-patients-with-acute-ischemic-stroke
Tadi, P. (2023, August 17). Acute stroke (nursing)https://www.ncbi.nlm.nih.gov/books/NBK568693/
