Left Posterior Cerebral Artery Infarction (Stroke)

A stroke occurs when there is ischemia (inadequate blood flow) to a part of the brain or hemorrhage into the brain that results in death of brain cells. Functions such as movement, sensation, or emotions that were controlled by the affected area of the brain are lost or impaired. The severity of the loss of function varies according to the location and extent of the brain involved. Common long term disabilities include hemiparesis, inability to walk, complete or partial dependence in ADLs, aphasia, and depression. Modifiable risk factors for having a stroke include hypertension, heart disease, smoking, excessive alcohol consumption, obesity, sleep apnea, metabolic syndrome, lack of physical exercise, poor diet, and drug abuse. Hypertension is the single most modifiable risk factor, but it is still often undetected and inadequately treated. Stroke risk can be reduced up to 50% with appropriate treatment of hypertension***. Diabetes mellitus is also a significant risk factor for a stroke. The risk for stroke in people with diabetes mellitus is 5x higher than in the general population. Increased serum cholesterol and smoking are risk factors for stroke. Smoking nearly doubles the risk of having a stroke. The risk

associated with smoking decreases substantially over time after the smoker quits. After 5-10 yrs of no tobacco use, former smokers have the same risk of stroke as nonsmokers. In addition, patient is obese. Obesity is also associated with hypertension, high blood glucose, and elevated blood lipid levels, all of which increase the risk of having a stroke (Lewis, Dirksen, Heitkemper, Bucher, & Camera, 2011).

References Lewis, S. L., Dirksen, S. R., Heitkemper, M. M., Bucher, L., & Camera, I. M. (2011).

Medical-Surgical Nursing: Assessment and Management of Clinical Problems

Journal Writing ARU Experience Kelsey LeVan Learning Objectives 1. During my experience on ARU, I will assist in transferring patients. 2. During my experience on ARU, I will learn at least one fact on how stroke patients regain their cognitive abilities. 3. During my experience on ARU, I will do ADLs for my patient, and ask for help from other staff if I need it. I plan to achieve objective one by doing hourly rounds on my patient to make sure she doesnt need to use the bathroom or would like to get in or out of bed. I will also achieve this objective by being with the patient for physical therapy and occupational therapy. To achieve objective 2, I will ask questions during speech therapy. To achieve objective three, I will introduce myself to staff and also check my patients PT/OT/Speech schedule to make sure she had an evaluation before I do her ADLs.

My experience on ARU was excellent. I felt the staff were very helpful and were eager to help me if I asked for it. During this experience, I did do a lot of toileting and bathing, and transferring my patient with the help of another staff member. This experience taught me that it is important to allow patients the opportunity to help themselves. I am very used to doing everything for the patient (transferring patient with a lift, doing all the work) instead of letting the patient try. This for me, was the hardest habit to break. During my experience, I also felt information from Nursing 100 was being applied. When it was applied, it made more sense. For instance, during Nursing 100 we learned that it is important to increase mobility therefore helping the bowels move. In addition, during my experience on ARU, I learned that a stroke patient may get stuck on a certain word, repeating it over and over (perseveration). I was able to complete all learning objectives. This was due to my experience on 4B last semester. I didnt have any difficulty completing any of my learning objectives.

If I had done anything differently, I would have made sure that I knew my medications. I didnt give meds, but I still would feel better if I knew them. I would change this by studying them when I write about them on my Molly.