Critical Appraisal

Strokes are commonly associated with old age, symptoms and awareness are often unnoticed in young adults due to ambiguity about strokes.

J. (2015). Addressing the burden of stroke caregivers: a literature review. Journal of Clinical Nursing, 24(17-18), 2376-2382. doi:10.1111/jocn.12884

In professional experience working at a comprehensive stroke center, early intervention in crucial in decreasing the amount of deficits stroke victims acquire. As I further my education and professional status in the field of Nurse Practitioner, I will be able to participate in in-depth research related to cerebrovascular accidents and quality patient outcomes.

The purpose of this essay is to discuss the care given to a stroke patient with complex care needs in a community setting. A critical analysis of the nurse’s role in care delivery will be explored. This essay will focus on three key aspects of care, which are mobility, nutrition, and cognitive impairment and a rationale for the chosen needs will be given. The author will evaluate and analyse the chosen nursing care approach utilised and its effectiveness in facilitating the care given. A discussion of the psychological, physiological, and social factors influencing the patients’ needs will follow. Furthermore, the author will identify and explore on health promotion needs relating to the patient. Issues related to Inter-professional working

In elderly patients, the decision-making ability is deteriorated and this could lead to a delay to seek medical help (Ganzer, Insel, & Ritter, 2012). Several included studies in this review have demonstrated that women were significantly older than men when they got the stroke symptoms (Maeda, Toyoda, Minematsu, & Kobayashi, 2013; Park et al., 2013). Hence, advanced age is likely to be another cause of pre-hospital delay in females. Additionally, some studies in this review have determined that elderly females with acute stroke are more likely to live alone than males (Mandelzweig et al., 2006; Park et al., 2013; Smith et al., 2010; Yanagida et al., 2014). Furthermore, earlier research has reported that acute stroke patients who lived alone were 2.63 times more likely to have longer hospital arrival times than patients who lived with others (p < 0.001) (Eissa et al., 2013). Thus, another possible cause of the delay time in females could be living alone.

According to the Centers for Disease Control and Prevention (CDC) (2015) every year there are 800,000 individuals who have strokes. There are 610,000 first time cases and 185,000 recurring stroke individuals. It is important for caregivers to note that the increased risk of another stroke is higher after the first (CDC, 2015). It is also critical for the caregiver to ask questions of the physician, such as what aspects physiologically and emotionally have been affected and treatments

The long term effects of a stroke are different from person to person. If the right side of the brain was damaged the left side of the body will be affected and if the right side of the brain is damaged the left side of the body will be affected, also the left side damage to the brain will affect Speech, Balance, Vision and breathing ("Treatment - Stroke - Mayo Clinic," 2015). Extensive therapies are require after a stroke these are physical therapy, occupational therapy and speech therapy. There is also rehabilitation services through in home care, hospitals or skilled nursing facility’s depending on the circumstances. Counseling is available to help cope with the new changes happening to the inside and outside of the body ("Treatment - Stroke - Mayo Clinic," 2015). There are a few alternative treatments available to they are not approves by the food and drug administration ("Stroke Alternative Treatments," 2013). Some of these natural therapies would include aromatherapy, massage therapy and yoga, these help reduce stress and relax the mind and body ("Stroke Alternative Treatments," 2013). Some patients controlled their diet by taking notice of the amount of cholesterol that they were taking in from foods they were eating ("Stroke Alternative Treatments,"

Led by our chairs Samantha Sangabi and Julia Roh, our Power to End Stroke initiative has worked to break the barrier that lies between the community and the signs of stroke. With the help of the B.E.F.A.S.T method we have been able to reach out to the community and provide patients with the tools to detect and take preventative measures against stroke.

Lastly, Ischaemic stroke is fatal in one third of cases, making it the third most common cause of death in developed counties (Nedeltchev & Mattle 2014, pp. 124-129). Among the survivors of stroke, at least half are permanently disabled, making stroke a major cause of long-term physical, cognitive, emotional, and social disability (Redfern, Mckevitt & Wolfe 2006, pp. 123-141). However, there has been a reduction in stroke deaths over the last ten years due to an increase in public awareness through programs and education around reducing risk factors for stroke (AIHW 2013). These programs targeted specific causes, such as; smoking,

Treatment of stroke, in general and ischemic stroke specifically, in particular, is aone of the most pressing issues in both nursing and medical science today. This is due to the fact that there are very few available treatment options for the various kinds of stroke. Acute ischemic stroke carriesis a prominent medical issue with a high risk of death or morbidity (Kakma, Stofko, Binning, Liebman & Veznedaroglu, 2014). Stroke, including ischemic and other types, is recognized, further, as a one of the most prominent leading causes of disabilities (Saver et al., 2015). While cerebral infarction resulting from thrombotic occlusion of brain arteries is the most common stroke type, ischemic stroke is also quite common. Each year ischemic stroke affects over a half-million victims in the United States alone;. o Of this group, about 150,000 deaths occur, along with 300,000 victims suffering from any number of disabilities following a stroke (CITE)after the fact.

Stroke is the fourth leading cause of death in the United States. Each year more than 795,000 Americans suffer from a stroke, which means that every forty seconds someone has stroke (Liebman, 2012). Although a stroke can occur at any age, strokes are frequently seen in the older adult demographics. An increase with age doubles the risk for a stroke each decade after 55 (Grysiewicz, 2008). The percentage of stroke survivors to almost fully recover from a stroke is only 10 percent; in contrast, 40 percent of stroke survivors will face moderate to severe impairment which will entail distinctive care (Perlmutter and Colman, 2005). When all strokes are analyzed according to demography of class system, approximately 60% of strokes occur in low or middle income countries (Silverman and Rymer, 2009).

Stroke, or brain attack, is the number four killer of adults in the world. In the United States, 160,000 deaths occur each year. From 1999 to 2009, the death rate from stroke gradually lowered as improvements to medicine and testing developed. Yet, 800,000 Americans continue to have strokes and survive the event. Worldwide, about 15 million experience stroke with 6 million who die and 5 million who become permanently disabled. (Robinson, Richard & Odle, Teresa G. & Frey, Rebecca J. & Odle, Teresa G. , 2011) The statistics in America are better for surviving a stroke because of rapid response and better interpretation of symptoms. Nevertheless, surviving a stroke often brings on dilapidating effects; which means a change in lifestyle and lifelong rehabilitation through physical therapy.

Stroke is a public health burden that affects 15 million people worldwide (World Health Report, 2002), approximately 795,000 people per year in the United States (Centers for Disease Control and Prevention, America’s Burden on Stroke, 2012) and specifically in Mississippi, stroke is the fifth leading cause of death (Mississippi Vital Statistics, 2014). Approximately 610,000 are first or new strokes and approximately 185,000 strokes, nearly one of four,four; occur in individuals that have had a previous stroke (Mozaffarian, Benjamin, Go, et al, 2015). Currently, there are more than 6.2 million noninstitutionalized adults who have had a stroke in the United States (Faststats, CDC, National Center for Health Statistics, 2012).

Stroke survivors commonly experience medical complications during their rehabilitation stay. Depression, urinary tract infection, and limb pain have been reported as three of the most common complications experienced among stroke survivors (Doshi et al., 2003, McLean, 2004). The use of medical tubes (tracheostromies, enteral feeding tubes, and indwelling urinary catheters), and associated complications, are also on the increase in rehabilitation units (Roth and Lovell, 2003). (Ostwald, Sharon K., et al.,

Stroke is seen as a major health concern and this is due to the fact that every year, as many as 110,000 individuals suffers from strokes making it a key issue. (NHS 2014)