A stroke is caused by a disruption of the blood flow to the brain. This disruption causes the death of brain cells.

There are four types of strokes:

TIA: A transient ischemic attack is a temporary attack that may last only a few minutes or up to 24 hours. Sometimes it is so mild that it goes unnoticed. A TIA is a warning that a more serious stroke may occur.
RIND: A reversible ischemic neurologic deficit is similar to a TIA, except the symptoms last from several days to a week. As with a TIA, the damage usually clears completely or is minimal. However, the likelihood or a major stroke is great.
SIE: A stroke in evolution is a stroke in the process of taking place. There is a gradually increasing weakness on one side of the body.
CS: A complete stroke exhibits all of the signs and symptoms of a stroke.

The symptoms of a stroke can vary greatly-here are some of the most common:

dizziness
poor coordination
headache
mental confusion
aphasia (difficulty speaking)
weakness in one hand or on one side of the body
unconsciousness

Your residents who have had a stroke need special nursing care for the complications related to paralysis or partial paralysis. Consider the following when caring for a stroke resident:

Decubitus ulcers
Special mattresses and pads, proper skin care and frequent turning can prevent or minimize the occurrence of pressure ulcers. Always follow your facility’s policies and procedures concerning decubitus ulcers.
Contractures
Proper body alignment must be maintained to prevent contractures. Take special care to maintain residents’ feet in their normal position.
Pneumonia
Frequent turning and position changes move the fluid that collects in the lungs. Great caution should be taken when feeding a partially paralyzed resident to prevent aspiration pneumonia. Encourage the resident to cough often, as this reduces the amount of mucus in the lungs.
Urinary and fecal incontinence/retention
This is a very common result of a stroke. Recording intake and output and bowel habits permits early intervention before a problem becomes too serious. Get the resident on a regular toileting schedule or offer the bedpan at regular intervals.
Falls
Stroke residents have a distorted sense of the location of the affected side of the body. Assist the person with ambulating and transferring until you determine it is safe without you.

Physical, occupational, and speech therapy can greatly improve the status of a resident who has had a stroke. In addition, family members and staff have a tendency to do too much for stroke residents. Although you should help with things they are unable to do on their own, the more stroke residents are encouraged to do, the better they feel and the more complete the recovery.

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