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Stroke CEU Online Continuing Education Course. Copyright © 2. 01. Wild Iris Medical Education, Inc. All Rights Reserved. LEARNING OUTCOME: Upon completion of this continuing education course, you will demonstrate an understanding of the anatomical alterations, pathophysiology, diagnosis, evaluation, and treatment options, emphasizing acute care and initial rehabilitation, for patients who have experienced a stroke. A stroke—also called a cerebrovascular accident (CVA) or a brain attack—is a reduction or an interruption of the flow of blood through an artery to one or more areas of the brain within the territory supplied by that artery.
The end result is varying degrees of neurological and/or cognitive malfunction lasting longer than 2. A very severe stroke can cause sudden death. Stroke is a medical emergency, and for persons experiencing a stroke, the difference between recovery and disability or death is measured in hours. For healthcare professionals it is imperative that an understanding of stroke and the ways to take action become part of day- to- day practice. Providers are responsible for improving their skills along the continuum of care from prehospital/acute stroke to post- stroke education. In addition, educating patients about stroke prevention and recognition of stroke should be part of every provider’s practice.
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EPIDEMIOLOGYAn estimated 6. Americans aged 2. The American Heart Association projects that by 2. Each year over 7. Americans experience a new or recurrent stroke. An estimated 6. 10,0.
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On average, someone in the United States has a stroke every 4. In 2. 01. 3, stroke was the cause of one of every 2.
United States. Stroke is the fifth- leading cause of death in the United States and the leading cause of serious long- term disability in America.(Mozaffarian et al., 2. AHA/ASA, 2. 01. 5b)By Age. The chance of having a stroke approximately doubles for each decade of life after 5. Although the prevalence of stroke is higher among older adults, approximately 1.
Stroke may also occur in infants and children and can even occur before birth (AHA/ASA, 2. By Gender. Each year, women have more strokes than men, and a stroke kills more women than men.
About 6. 0% of stroke deaths occur in females and 4. The use of birth control pills, pregnancy, history of preeclampsia/eclampsia or gestational diabetes, smoking, and post- menopausal hormone therapy are believed to account for this difference (AHA/ASA, 2. Watch Rosewater Youtube. By Race. The risk of having a first stroke is almost twice as high for blacks than for whites, and blacks are more likely to die following a stroke than are whites, partially due to the higher prevalence of high blood pressure, diabetes, and obesity among this population (AHA, 2. The incidence of stroke among Hispanics lies between that of whites and blacks. Native Americans, Alaska Natives, and blacks are more likely to have a stroke than are other groups (CDC, 2.
A higher incidence of intracerebral hemorrhage has been noted in Chinese, Japanese, and other Asian populations, possibly due to environmental factors (e. Liebeskind, 2. 01. By Geographic Location. The southeastern part of the United States has been nicknamed the “stroke belt,” which includes the following eleven states: Alabama.
Arkansas. Georgia. Indiana. Kentucky. Mississippi. Louisiana. North Carolina. South Carolina.
Tennessee. Virginia. This part of the country has an 1. This is believed to be the result of more limited access to healthcare as well as lower economic status affecting the quality and frequency of healthcare visits.
In addition, ethnic- specific risks and unhealthy lifestyle traditions and patterns are believed to be contributors (Jensen, 2. Source: CDC.)Effects of Stroke. Worldwide, stroke is the second- leading cause of death and the leading cause of adult disability (AHA/ASA, 2. WHO, 2. 01. 4). Receiving the diagnosis of stroke is frightening. A stroke can have profound effects on the body as well as the mind and emotions. Effects on the body may include weakness or paralysis of the extremities, swelling of the arms or legs, stiff or painful joints, muscle tingling and spasms, or the loss of ability to perceive heat or cold.
A stroke can leave a person with fatigue that makes everyday tasks difficult to accomplish. Strokes can seriously affect how the brain processes information, depending on where the damage has occurred. Memory, ability to learn, and general awareness of surroundings can be affected, as well as the ability to communicate through speech and writing. Reading ability and concentration may also be impaired.
Sleep disturbances may result in increased impairment of memory and perception. Emotionally, a stroke can cause feelings of fear, anxiety, or depression and can result in damage to areas of the brain responsible for regulating emotions, leading to emotional lability and personality or character changes. Finally, the loss of independence that results from all of these can be the most devastating consequence of having a stroke. Economically, in 2. CDC, 2. 01. 5). RISK FACTORSSome risk factors are nonmodifiable: Low birth weight is reported to be associated with increased hemorrhagic stroke risk in adult life. Male gender increases the risk for ischemic stroke.
Early menopause increases the risk for subarachnoid hemorrhage in women. Stroke increases markedly with age in both men and women for both ischemic and hemorrhagic stroke.
People of African origin have a higher risk than whites. Genetics may play a role in the increased susceptibility of stroke (e. Other risk factors are modifiable: Hypertension is the most important treatable risk factor for stroke. Atrial fibrillation can cause emboli to travel to the brain. Coagulation disorders have been implicated in ischemic stroke.
Diabetes mellitus causes hyperglycemia, which in turn leads to increased fatty deposits or clots on blood vessel walls. Lifestyle factors impact the risk. Smoking (doubles the risk for ischemic stroke)Excessive alcohol consumption (however, individuals who do not use any alcohol may have a slightly increased risk as well)Drug abuse. Obesity. Lack of physical activity. Psychological stress.
Lower socioeconomic status. Poor or inadequate nutrition(Lindgren, 2. Scientists at the National Institute of Neurological Disorders and Stroke (2. Americans should be able to prevent 8. For instance, improved nutrition—including a high- vegetable, low- fat, high- fiber diet—and regular aerobic exercise have been shown to reduce risk.
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