Describing Ischaemic Stroke to Patients and Healthcare Professionals

This article provides a comprehensive description of Ischaemic Stroke, including its causes, symptoms, diagnosis, and treatment. It also offers resources for patients, nurses, and doctors to learn more about the condition. Desklib is your go-to online library for study material.

[Topic: Ischaemic Stroke]
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Describing Ischaemic Stroke to a patient or family member
The disease condition that has been chosen for description is the ischaemic stroke. An
Ischaemic stroke is said to occur when a blockage occurs within an artery that
communicates with the brain. Ischemic stroke can be triggered by a number of diseases. The
problem causes narrowing of the arteries with the head and neck region. The narrowing of
the arteries is caused due to the deposition of cholesterol within the artery, a condition also
known as atherosclerosis (Nucleus Medical Media 2019). A number of lifestyle factors
triggers the onset of the disorder and include habits such as consumption of street drugs.
Also, traumatic injury caused to the blood vessels around the neck could lead to the
disorder.
Describing Ischaemic Stroke to a Nurse
According to a report published by Wardlaw et al. (2014), it has been estimated that
Ischaemic stroke causes a total of 8,200 deaths across Australia. Ischaemic stroke can be
precisely referred to as a brain attack that is caused when substantial blood flow does not
reach to the brain cells and there is a lack of oxygen supply within the brain.
As stated by Sandercock, Counsell and Kane (2015), care professionals are expected to
lower the death or disability risk from stroke by actively regulating the risk factors that lead
to the stroke and be aware of the warning signs and symptoms. According to a research
conducted by Emberson et al. (2014), the warning signs of Ischaemic stroke includes the
following:

 Patient experiences numbness or weakness within the arm, leg or face or numbness
is restricted to one side of the body
 Patient experiences sudden confusion is unable to frame appropriate speech or
respond to speech appropriately
 Experiences problems with clear vision
 Experiences problems related to improper balance and coordination and feels dizzy
 Experiences headache without an underlined cause
 Double vision
 Drowsiness
 Vomiting and nausea
Upon recovery, a multidisciplinary team should be involved for rehabilitation which
must comprise of a physician, occupational therapist, speech pathologist, psychiatrist,
Dietician, nurse and a dietician, depending upon the recovery needs of the patient
(Mayoclinic.org 2019).
Throughout the care process, the nurses must empathise with the family members and
adapt a person-centred approach to care for the patient (Mayoclinic.org 2019).
Additionally, after recovery the care process should be planned by actively partnering with
the patient and the family members in order to ensure effective decision making and
positive recovery.
Describing Ischaemic stroke to a Doctor:
Doctors upon attending a patient in the emergency department must essentially
identify the type of stroke with the help of a diagnostic procedure. The diagnostic tests and
procedures that can help in the identification of an Ischaemic stroke includes, physical
examination of the patient, CT scan, blood tests (documenting rate at which blood clots,

blood glucose level and percentage of blood components), MRI, Carotid Ultrasound,
Cerebral angiogram as well as an Echocardiogram. The primary treatment intervention must
comprise of commencing clot-busting medication after analysing the diagnostic tests.
Further as per Sandercock et al. (2015), administering intravenous injection of tissue
plasminogen activator can help in dissolving the blood flow and restore normal blood clot.
Additionally, emergency endovascular procedures such as delivering direct medication to
the brain and removal of clot with a stent retriever can be commenced in consultation to
ensure effective blood circulation. It is important to reduce subsequent recurrence of a
stroke and this can be ensured with the commencement of carotid endarterectomy and
angioplasty (Sandercock et al. 2015).
Carotid endarectomy involves removal of plaque from arteries that run along the
adjacent sides of the neck to the brain. The procedure is followed by making an incision on
the frontal portion of the neck and opening the carotid artery and then removal of the
plaque that blocks the carotid artery. The surgeon then repairs the artery by a patch made
from the vein, by using an artificial graft or through stitches. The procedure involves risks in
patients who have cardiovascular issues. The angioplasty procedure involves assessing the
carotid arteries through the groin. The carotid arteries are then assessed within the neck. An
inflated balloon is used to expand the artery and a stent is inserted to provide support to
the opened artery.
Three best resources
Resource for a patient or family member

Resource: Strokecenter.org 2019. Ischemic Stroke | Internet Stroke Center. [online]
Strokecenter.org. Available at: http://www.strokecenter.org/patients/about-stroke/ischemic-
stroke/ [Accessed 6 May 2019].
Link: http://www.strokecenter.org/patients/about-stroke/ischemic-stroke/
Rationale: The resource contains information about Ischaemic stroke. Ischemic stroke is
regarded as the most common form of stroke that largely attributes to 88% of all the strokes
that affect people. Individuals across all age groups including minors can experience a
stroke. However, it is important to consider here that in general people aged 60 years and
older are affected by Ischaemic stroke and the risk of suffering from a stroke increases with
advancing age. Every year approximately 55000 women suffer from Ischaemic stroke
(Strokecenter.org 2019). The occurrence is more common in women than in men and among
the individuals belonging to the African-American community. Physical health conditions
such as hypertension, cardiovascular disorders, increased smoking or Diabetes serve as risk
factors that enhance the possibility of suffering from an Ischaemic stroke.
Resource: Nucleus Medical Media 2019. https://www.youtube.com/watch?v=7FR1TsKLoDI.
[image].
Link: https://www.youtube.com/watch?v=7FR1TsKLoDI.
Rationale: The resource contains an illustration on Ischemic stroke. The disorder could be
divided into two subtypes that include thrombotic and embolic. A thrombotic stroke takes
place when the arteries present within the cerebral region are blocked due to the formation
of blood clot within the brain. This condition is also known as cerebral infarction or cerebral
thrombosis. Cerebral thrombosis can be divided into two sub-categories that relate with the
location of blockage in the brain and are divided into large vessel and small vessel
thrombosis (Nucleus Medical Media 2019). Large vessel thrombosis occurs if there is a

blockage within the larger blood supplying arteries of the brain such as the middle cerebral
artery or the carotid artery. On the other hand, small vessel thrombosis occurs if there is a
blockage with the deep and penetrating arteries. The embolic stroke on the other hand is
also caused due to blockage within an artery but the blockage or the clot occurs somewhere
else than the brain (Nucleus Medical Media 2019). The blockage usually occurs within other
region and travels to other places by means of blood circulation. This leads to restriction of
the blood flow and causes deficits in the immediate physical and neurological functions.
Resource: Mayoclinic.org 2019. Stroke - Diagnosis and treatment - Mayo Clinic. [online]
Mayoclinic.org. Available at:
https://www.mayoclinic.org/diseases-conditions/stroke/diagnosis-treatment/drc-20350119
[Accessed 6 May 2019].
Link: https://www.mayoclinic.org/diseases-conditions/stroke/diagnosis-treatment/drc-
20350119
Rationale: The resource highlights the signs and symptoms of Ischaemic stroke. The
warning signs of stroke include sudden feeling of numbness within the face, arm or leg,
typically on one side of the body, sudden confusion or trouble in framing or perceiving
speech, trouble with vision, trouble experienced while walking accompanied with dizziness
or loss of balance and experiencing sudden headache without a proper cause
(Mayoclinic.org 2019). Upon experiencing two or more of the mentioned symptoms, 911
emergency must be contacted for immediate assistance.
Resource for a Nurse
Resource: Wardlaw, J.M., Murray, V., Berge, E. and del Zoppo, G.J., 2014. Thrombolysis
for acute ischaemic stroke. Cochrane database of systematic reviews, (7).
Link: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD000213.pub3/abstract

Rationale: The resource mentions about the pathophysiology of Ischaemic stroke. Ischaemic
stroke is broadly subdivided into two categories which is either characterized by a blockage
of the blood flow or by bleeding into the brain. Typically, a blockage of the blood vessel
located in the brain or neck is known as ischaemic stroke. The blockage is caused due to
three conditions which can be explained as formation of clot within the blood vessel of neck
and brain or thrombosis, movement of the blood clot to the vital organs of the body such as
the brain or the heart, known as embolism or constriction of the arteries communicating
with the brain; referred to as stenosis (Wardlaw et al. 2014). Additionally, the second type
of stroke caused on account of bleeding into brain is referred to as haemorrhagic stroke.
Resource: Emberson, J., Lees, K.R., Lyden, P., Blackwell, L., Albers, G., Bluhmki, E., Brott,
T., Cohen, G., Davis, S., Donnan, G. and Grotta, J., 2014. Effect of treatment delay, age, and
stroke severity on the effects of intravenous thrombolysis with alteplase for acute ischaemic
stroke: a meta-analysis of individual patient data from randomised trials. The
Lancet, 384(9958), pp.1929-1935.
Link: https://www.sciencedirect.com/science/article/pii/S0140673614605845
Rationale: The resource highlights the risk factors associated with Ischaemic stroke. Care
professionals must be aware about the risk factors that trigger the probability of suffering
from stroke. The risk factors include, advancing age, ethnic and gender considerations and
family history of stroke. Research studies suggest that the risk of suffering from stroke is
extremely high among patient in between 55 to 85 years of age (Emberson et al. 2014).
Further, at the middle age, men are susceptible to suffer from stroke, on the contrary in the
advancing years, females are more susceptible to suffer from strokes. Further, research
studies indicate that African Americans and Hispanic Americans, particularly Caucasians are
at a higher risk of suffering from Ischaemic stroke than whites. Also, studies suggest that

chances of suffering from a stroke is high in case of patients where there is a family history
of Diabetes and hypertension (Emberson et al. 2014). Further, lifestyle risk factors that
trigger stroke include hypertension, smoking, Diabetes, obesity, cholesterol imbalance as
well as history of other cardiovascular disorders.
Resource: Sandercock, P.A., Counsell, C. and Kane, E.J., 2015. Anticoagulants for acute
ischaemic stroke. Cochrane Database of Systematic Reviews, (3).
Link: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD000024.pub4/
abstract
Rationale: The resource contains information about the diagnostic tests and the treatment
procedure associated with Ischaemic stroke. Upon attending a patient in the emergency
department, it is important to identify the type of stroke, which can be confirmed on the
basis of physical examination, CT scan, blood tests (documenting rate at which blood clots,
blood glucose level and percentage of blood components), MRI, Carotid Ultrasound,
Cerebral angiogram as well as Echocardiogram can help in assessing the type and intensity
of stroke. The primary treatment intervention must comprise of commencing clot-busting
medication after consulting with the physician. Further, administering intravenous injection
of tissue plasminogen activator can help in dissolving the blood flow and restoring normal
blood circulation (Sandercock et al. 2015). Additionally, emergency endovascular
procedures such as delivering direct medication to the brain and removal of clot with a stent
retriever can be commenced in consultation with the physician. It is important to reduce
subsequent recurrence of a stroke and this can be ensured with the commencement of
carotid endarterectomy and angioplasty (Sandercock et al. 2015).