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Ischemic Stroke, Ambulatory Care


An ischemic stroke

happens 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.

Common symptoms include the following:

  • Severe headache
  • Blurred or double vision, or vision loss
  • Numbness, tingling, weakness, or paralysis on 1 side of your body
  • Trouble walking or communicating
  • Dizziness, confusion, or fainting

How can I tell if someone is having a stroke?

Know the F.A.S.T. test to recognize the signs of a stroke:

  • F = Face: Ask the person to smile. Drooping on one side of the mouth or face is a sign of a stroke.
  • A = Arms: Ask the person to raise both arms. One arm that slowly comes back down or cannot be raised is a sign of a stroke.
  • S = Speech: Ask the person to repeat a simple sentence that you say first. Speech that is slurred or sounds strange is a sign of a stroke.
  • T = Time: Call 911 if you see any of these signs. This is an emergency.

Call 911 for any of the following:

  • A seizure
  • Lightheadedness, shortness of breath, and chest pain
  • Coughing up blood
  • Weakness or numbness in your arm, leg, or face
  • Confusion and problems speaking or understanding speech
  • A severe headache, or loss of balance or coordination

Treatment for ischemic stroke

may include any of the following:

  • 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.
  • Blood thinners help prevent blood clots. Examples of blood thinners include heparin and warfarin. Clots can cause strokes, heart attacks, and death. The following are general safety guidelines to follow while you are taking a blood thinner:
    • Watch for bleeding and bruising while you take blood thinners. Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin, and a soft toothbrush to brush your teeth. This can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports.
    • Tell your dentist and other healthcare providers that you take anticoagulants. Wear a bracelet or necklace that says you take this medicine.
    • Do not start or stop any medicines unless your healthcare provider tells you to. Many medicines cannot be used with blood thinners.
    • Tell your healthcare provider right away if you forget to take the medicine, or if you take too much.
    • Warfarin is a blood thinner that you may need to take. The following are things you should be aware of if you take warfarin.
      • Foods and medicines can affect the amount of warfarin in your blood. 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 and certain other foods. Ask for more information about what to eat when you are taking warfarin.
      • You will need to see your healthcare provider for follow-up visits when you are on warfarin. You will need regular blood tests. These tests are used to decide how much medicine you need.
  • 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.

Go to physical or occupational therapy:

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.

Prevent another stroke:

  • Manage health conditions. Take your medicine as directed. Check your blood pressure and blood sugar levels as directed. Keep a record and bring it to your follow-up visits.
  • Eat a variety of healthy foods. Healthy foods include whole-grain breads, low-fat dairy products, beans, lean meats, and fish. Eat at least 5 servings of fruits and vegetables each day. Choose foods that are low in fat, cholesterol, salt, and sugar. Eat foods that are high in potassium, such as potatoes and bananas.
  • Maintain a healthy weight. Ask your healthcare provider how much you should weigh. Ask him to help you create a weight loss plan if you are overweight. Ask about the best exercise plan for you.
  • Limit or do not drink alcohol. Limit alcohol to 2 drinks per day if you are a man. Limit alcohol to 1 drink per day if you are a woman. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor.
  • Do not smoke cigarettes or use street drugs. Smoking and drugs increase your risk for a stroke. Ask your healthcare provider for information if you need help quitting.
  • Get a flu vaccine. To prevent influenza (flu), all adults should get the influenza vaccine. Get the vaccine every year as soon as it becomes available.

Follow up with your healthcare provider or neurologist as directed:

You may need to come in for regular tests of your brain function. You may also need regular blood tests. Write down your questions so you remember to ask them during your visits.

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. 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.

© 2016 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.