Jason C. Zydallis Raritan Valley Community College Nursing
Slide 2
What is a Stroke? o Interruption of blood flow to the brain
resulting in tissue ischemia or death o Commonly known as a Brain
Attack o Strokes are Medical Emergencies! o Brain cells begin to
die from lack of oxygen o The extent of disability is dependent on
the area of the brain involved. o Early Treatment is key to
decreased disability
Slide 3
Stroke Statistics o Each year 700,000 Americans suffer a stroke
o Stroke is the 3 rd leading cause of death among cancer and heart
disease o Stroke accounts for more serious long term disabilities
than any other disease o Highest risk after age 65, however, the
risk of stroke doubles each decade after 55 o Stroke is more common
in men especially African Americans.
Slide 4
Types of Strokes o Ischemic stroke restriction of blood supply
to the brain resulting in inadequate oxygen o Two types :
Thrombotic and Embolic o Thrombotic strokes result from developing
a clot usually due to vessel narrowing over time o Embolic strokes
results when a piece of an existing clot breaks off and occludes a
vessel o Ischemic strokes are the most common types of strokes o
Hemorrhagic strokes are the second type of stroke and are caused by
ruptures vessels inside the brain
Slide 5
Normal vs. Occluded Artery Ischemic Stroke Many factors lead to
the occlusion of arteries such as high blood pressure, diabetes,
smoking, and high cholesterol diets
Slide 6
Cerebral Hemorrhage (Bleeding) High blood pressure is #1
cause!!
Slide 7
Transient Ischemic Attack (TIAs) o More commonly known as Mini
Strokes o Are considered a warning sign of progressive
cerebro-vascular disease (vessels of the brain) o Many only last up
to an hour but can last for 24 hours
Slide 8
TIA Signs and Symptoms o Signs: Sudden severe headache with no
known cause o Temporary loss of vision in one eye or double vision
o Numbness or loss of sensation to one or both sides of the body o
Inability to speak o Dizziness o Facial drooping o Difficulty
walking o Difficulty swallowing o These are not normal occurrences.
Seek Emergency Care! o If untreated symptoms may resolve, but can
progress to a full blown stroke!
Slide 9
Nonmodifiable Risk Factors These are the factors that we have
no control over but may increase the risk of stroke Age Over 65
stroke increases Gender Men have increased risk but women have an
increased mortality rate Race African Americans have increased risk
Family History Prior history of TIAs or past strokes increases the
risk for having another attack Important: Present any symptoms to
your physician!
Slide 10
Modifiable Risk Factors o These factors are controllable and
prevent the risk of stroke o High Blood Pressure alone is the
highest risk for stroke and is the least recognized (50% increase
in risk) o Heart Disease Atrial Fibrillation the most common
arrhythmia and most treatable (20% increase in risk) o Diabetes -
Increases the risk by 5 times the normal population for
uncontrolled blood glucose o Smoking Doubles the risk of having a
stroke o Cholesterol High fat diets increase narrowing of the
arteries o Obesity Increases blood pressure, fat molecules in the
arteries, and high blood glucose o Sedentary Lifestyle Lack of
exercise
Slide 11
What do we do to decrease our risk? o Addressing our modifiable
factors o Consume a healthy diet with less fats and increased
fruits and vegetables also decrease salt intake o Weight Control
helps decrease risk for increased blood pressure o Blood Pressure
Control Check your blood pressure often and adhere to medicine
regimen o Regular exercise 30mins of walking 3 times per week has
shown great benefit to cardiovascular health o Stop Smoking Smoking
both damages and constricts vessels in your body o Regular visits
to your primary care provider to maintain best quality of
health
Slide 12
What can medicine do for you? o Many advances in healthcare
have been made which greatly increase our life expectancy o Here
are some procedures that can decrease the risk of suffering a
stroke o Carotid Endarterectomy Surgical procedure to manually
remove the build up of plaque inside of the carotid artery o
Carotid Angioplasty Same day procedure, vessels accessed through
your groin and the artery is opened and stented to ensure positive
blood flow o MERCI mechanical removal of the clot o Anti-platelet
drugs Help decrease the occurrence of clots in high risk patients
Ex: Aspirin, Plavix o Statins Decreases the cholesterol levels in
the blood which may decrease the buildup of additional plaques in
the vessel Ex: Lipitor, Zocor, and Mevacor o TPA Given for ischemic
strokes only can be administered to help decrease effects of a
stroke. Only given to those who meet strict criteria and requires
inpatient monitoring in a medical facility o As you can see there
are many options for care as well as following the guide to
prevention of strokes
Slide 13
Lipids and Cholesterol Important to monitor cholesterol levels
as well as the amount of fats in your diet LDLs Bad Cholesterol
should be lower than 100 mg/dl HDLs Good Cholesterol should be
greater than 40 mg/dl **If your doctor tells you that you have High
Cholesterol ask for the results** Sample Lipid/Cholesterol
Panel
Slide 14
Insulin Insulin control is very important to prevent damage to
blood vessels Glucose monitoring should be implemented if you have
diabetes and strict adherence is necessary General information
about Glucose Levels and what they mean Normal Target Fasting Blood
Glucose for Non-Diabetics = 70-100 mg/dl and less than 130 mg/dl
after meals Normal Target Fasting Blood Glucose level for Diabetics
= 70-130 mg/dl and less than 180 mg/dl after meals
Slide 15
Blood Pressure Blood Pressure should be monitored regularly to
ensure normal levels Levels should be checked by your MD every
visit Monitors can be purchased for home usage Blood Pressure
Interpretations 120/80 mmHg Optimal 140/85 mmHg Pre-Hypertension
150/90 mmHg Stage 1 Hypertension 170/100 mmHg Stage 2 Hypertension
*Follow up with your PCP if you have episodes of High Blood
Pressure*
Slide 16
Body Mass Index (BMI) A comparison of height and weight on a
standardized scale Good = 19.5 25 Mild Obesity = 25-30 Obese =
>30
Slide 17
Anabolic Steroids and Stimulants Increase Blood Pressure
further increasing risk for stroke Increase the amount of
cholesterol in the blood Increased fluid retention in the body
increases blood pressure Stimulants increase pulse and metabolic
rate causing adverse cardiac function Before starting any weight
loss pills you should consult with your doctor because it may
interfere with current health problems
Slide 18
Alcohol Use More than 2 drinks a day increase risk by 50% Most
strokes occur within the first hour after alcohol consumption
Affects the liver thins the blood causing increased hemorrhagic
strokes. Increases the bad cholesterol in your blood resulting in
plaque accumulation in the vessels