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Ischemic Stroke

WHAT YOU SHOULD KNOW:

An ischemic stroke occurs when blood is suddenly blocked and cannot flow to your brain. The block is usually caused by a blood clot that gets stuck in a narrow blood vessel. When oxygen cannot get to an area of the brain, tissue in that area may get damaged. Damage to an area of the brain causes loss of body functions controlled by that area.


CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

You may get blood clots that can break loose and travel to your lungs or brain. You may have another stroke or go into a coma. You may be paralyzed on one or both sides of your body. You may not be able to care for yourself or live alone. You are at greater risk for falling. You may develop muscle shortening or bedsores. Even with treatment, you may have lasting problems talking, thinking, or moving your body. Without treatment, your risk for another stroke increases. This can be life-threatening.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

An IV

is a small tube placed in your vein that is used to give you medicine or liquids.

Tests:

  • A CT or MRI may show where the stroke happened and any damage you have. You may be given contrast liquid to help your skull and brain show up better in the pictures. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.

  • An arteriography is used to take x-rays of your arteries to look for blood flow blockage.

  • Frequent blood tests may be needed while you are being treated for your stroke. These tests can tell healthcare providers if you are getting the right amount of medicine.

  • A carotid ultrasound uses sound waves to show the blood flow in your carotid arteries. The carotid arteries are blood vessels in your neck that carry blood to your brain. A carotid ultrasound checks for narrow or blocked carotid arteries.

  • A swallow study is used to take x-rays as you swallow certain foods and drinks. This test shows if food and liquids travel to your stomach correctly.

Monitoring:

  • You may need extra oxygen if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils. Ask your healthcare provider before you take off the mask or oxygen tubing.

  • A neuro exam may show how well your brain works after a stroke. Healthcare providers will check how your pupils react to light. They may check your memory and how easily you wake up. Your hand grasp and balance may also be tested.

  • Intake and output may need to be measured. Healthcare providers may measure how much liquid you are getting and how much you are urinating.

  • A ventilator is a machine that gives you oxygen and breathes for you when you cannot breathe well on your own. An endotracheal (ET) tube is put into your mouth or nose and attached to the ventilator. You may need a trach if an ET tube cannot be placed. A trach is a tube put through an incision and into your windpipe.

  • An ICP monitor measures the pressure inside your skull. A small tube is put through your skull and connected to a screen.

Medicines:

  • Antiplatelets , such as aspirin, help prevent blood clots. Take your antiplatelet medicine exactly as directed. These medicines make it more likely for you to bleed or bruise. If you are told to take aspirin, do not take acetaminophen or ibuprofen instead.

  • Anticoagulants are a type of blood thinner medicine that helps prevent clots. Clots can cause strokes, heart attacks, and death. These medicines may cause you to bleed or bruise more easily.

    • Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth and a soft toothbrush. If you shave, use an electric razor. Avoid activities that can cause bruising or bleeding.

    • Tell your healthcare provider about all medicines you take because many medicines cannot be used with anticoagulants. Do not start or stop any medicines unless your healthcare provider tells you to. Tell your dentist and other healthcare providers that you take anticoagulants. Wear a bracelet or necklace that says you take this medicine.

    • You will need regular blood tests so your healthcare provider can decide how much medicine you need. Take anticoagulants exactly as directed. Tell your healthcare provider right away if you forget to take the medicine, or if you take too much.

    • If you take warfarin, some foods can change how your blood clots. Do not make major changes to your diet while you take warfarin. Warfarin works best when you eat about the same amount of vitamin K every day. Vitamin K is found in green leafy vegetables, broccoli, grapes, and other foods. Ask for more information about what to eat when you take warfarin.

  • Thrombolytics help break apart clots. These medicines make it more likely for you to bleed or bruise.

  • Other medicines may be given to treat high cholesterol, high blood pressure, or diabetes. You may also need medicine to decrease pain, reduce brain pressure, or prevent seizures.

Treatment:

  • You may need to wear pressure stockings or inflatable boots. The stockings are tight and put pressure on your legs. The boots have an air pump that tightens and loosens different areas of the boots. This improves blood flow and helps prevent clots.

  • Physical and occupational therapy may be needed. A physical therapist teaches you exercises to help improve movement and strength, and to decrease pain. An occupational therapist teaches you skills to help with your daily activities.

  • Bladder and bowel training helps you control when you urinate or have a bowel movement.

  • Swallow therapy may help you learn safe ways to swallow to prevent coughing and choking.

  • A feeding tube may be needed if you cannot swallow food or liquids.

  • Surgery may be needed to improve blood flow and prevent clots. A tube may be placed in your skull. The tube drains extra fluid and checks the pressure in your brain. You may also need surgery to widen arteries or to place a filter into a blood vessel.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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