NRS 410 Discuss characteristic findings for a stroke and how it affects the lives of patients and their families
NRS 410 Discuss characteristic findings for a stroke and how it affects the lives of patients and their families
After a stroke, there are a couple of reasons why a patient might start cursing. It may result from mental illness or rage. Due to the severity of the stroke, a significant shift in their life may occur causing the patient to become angry, which could make it difficult for them to maintain their lifestyle due to physical limitations. And cognitive impairment brought on by the brain damage caused by the stroke. Nurses can provide education about the effects of a stroke, refer family counseling/therapy, and provide emotional support (Grant, J.S. (2014).
Grant, J. S., Joan S. Grant From the School of Nursing, Hunt, C. W., Caralise W. Hunt From the School of Nursing, Steadman, L., Laura Steadman From the School of Nursing, Grant, C. to J. S., & Al., E. (2014, June 19). Common caregiver issues and nursing interventions after a stroke. Stroke. Retrieved July 26, 2022, from https://www.ahajournals.org/doi/10.1161/STROKEAHA.114.005094#:~:text=Emotional%20support%20can%20be%20provided%20through%20hugging%2C%20touching%2C,the%20past%20but%20rather%20maximizing%20the%20present.%2019
Stroke affects the lives of patients in negative ways. The issues are associated with depression, cognitive impairment, and personality concerns. To help families in these devastating situations, nurses are expected to ensure that they listen to them, show encouragement, and observe their patients identify additional signs and symptoms (Lehto et al., 2019). The nurse can also make referrals or use resources within the organization or community to assist the patient and family. For example, referring a stroke patient for psychological counselling will help in addressing the psychosocial characteristics of the patient’s health.
Lehto, B., Kylmä, J., & Åstedt‐Kurki, P. (2019). Caring Interaction with stroke survivors’ family members—Family members’ and nurses’ perspectives. Journal of Clinical Nursing, 28(1-2), 300-309. https://doi.org/10.1111/jocn.14620
Behavior changes can happen after a stroke, sometimes a normal part of the recovery process, but can also indicate other medical complications requiring treatment (Flint Rehab, 2021). Patients can have sudden and completely new personality traits and behaviors that shock their family and friends. A stroke causes damage to a patient’s brain; for example, damage to the frontal lobe can lead to impulsiveness and lack of self-control (Flint Rehab, 2021). They may have aphasia, and difficulty communicating, which in addition to the loss of their independence, can cause anger and frustration leading to cussing or outbursts. If they seem drastically different in demeanor and speech, it can be concerning for the family and difficult for them to understand, and they will require education and support too. Provide the family with education on how brain damage can contribute to the patient’s changes. Encourage the family to be patient and listen, but set limits by discussing their behavior and what is appropriate or not. They should get help from others, not try to do everything themselves, and not put themselves in danger. They should discuss behavior changes with the provider as they may have medical treatment or additional therapy that can help. The family can also join support groups or counseling for support. If the patient is verbally or physically aggressive, we must educate the family that it is ok to walk away, try not to raise their voice, and, if necessary, call 911.
Flint Rehab. (2021). Behavior changes after stroke: Causes & treatment. https://www.flintrehab.com/behavior-changes-after-stroke/
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I know from both professional and personal experience, that caring for stroke patients is emotionally taxing. I’ve seen otherwise docile, mild-mannered patients become aggressive, use foul language, and essentially transform into another person altogether.
What makes this phenomenon even more strange is the fact that many of these patients have a limited verbal vocabulary after suffering a stroke, but they swear and use profanity to no end! When a stroke has affected the area of the brain that controls speech, it may result in the use of profanity by a patient that has never spoken that way before. We can support the family by teaching them that it is not uncommon for this to happen in people post-stroke. While that may not necessarily quell their worry, fear, or embarrassment, helping them understand may help them to deal with the situation a little better. Kim (2016) suggests that encouraging family members to provide emotional support to the stroke patient also helps them [the family members]. Caregiver support groups can be a good outlet; not only can they find helpful advice on caring for stroke victims, but they can also meet like-minded peers who may offer them guidance and emotional support for what they’re dealing with. Sometimes just knowing that they’re not alone in a situation helps more than you know.
Kim, J.S. (2016). Post-stroke mood and emotional disturbances: Pharmacological therapy based on mechanisms. Journal of Stroke, 18(3), 244–255. https://doi.org/10.5853/jos.2016.01144
Stroke can have all sorts of different effects. Many are physical, that we can see and recognize but there can also be hidden effects, like emotional changes. Changing of emotions often lead to a change in behavior. If a patient’s emotions or behavior have changed since their stroke, this may be caused by physical damage to the brain. Different parts of the brain control different functions within the body, including how we feel. If the part of the brain that normally controls our emotions becomes damaged by a stroke, the result can be a change in how one can think, feel or behave (SA, 2012).
I work on a med surge floor and work with mainly the elderly population. I have had many situations where patients who come in altered or with dementia and start cussing. Because of this I feel I have the ability to remain calm in these situations. When a patient is a stroke survivor, I tend to see it a little differently. If a patient starts cussing who never did before the stroke occurred, they may feel angry and trapped inside because of what has happened. When this happens, I let them know that I am there for them. If the cussing is due to a cognitive component a patient may not be able to control their emotions or speech. I sometimes you just need to reinforce good language or possibly ignore the comments. Stroke victim patients would also benefit from things like speech therapy and cognitive/behavioral therapy. Family members of stroke victims should be involved in the treatment plan, it may get them to feel more at ease about the situation. Sometimes just holding a family members hand, letting them be comforted in your presence and openness to answer any questions that they may have, can be of big importance. The nurse should also get social work involved to come up with any available resources for the family, such as counseling, financing, and placement options if needed.
Stroke Association. (2012, April). A complete guide to emotional changes after stroke. Emotional changes after stroke. Retrieved July 29, 2022, from https://www.stroke.org.uk/sites/default/files/complete_guide_to_emotional_changes_after_stroke.pdf
According to (CDC, 2019), stroke is the fifth leading cause of death in the United States and is a major cause of thoughtful disability for adults. About 800,000 people in the United States have a stroke each year and it is a life-threatening medical condition, which happens when the blood supply to parts of the brain is cut off. Strokes is a medical emergency and important treatment is necessary. The sooner a person receives treatment for a stroke, the less damage is likely to happen. The sign and symptoms are the same for both men and women. Symptoms can happen rapidly, or they can come and go over a few days. The warning signs and symptoms of stroke include weakness on one side of your body; numbness or tingling in your face, arm or leg; trouble speaking or understanding what others say; vision problems, such as double vision or being unable to see, especially in one eye; dizziness, such as losing your balance.
Centers for Disease Control and Prevention. (2019, November 18). Stroke. Retrieved January 24, 2020, from https://www.cdc.gov/stroke/index.htm
A stroke can have devastating effects on the brain and body. A stroke happens when blood flow is stopped to an area of the brain by way of rupture- hemorrhagic stroke, or thrombus- ischemic stroke, in the blood vessel supporting the area (Falkner & Green, 2018). If a person is experiencing signs of a stroke, they will need emergency care. The signs include numbness or weakness on one side of the body, trouble speaking, confusion, slurred speech, trouble walking, or severe headache(Falkner & Green, 2018). If caught in time, stroke symptoms can be diminished with treatment, and delaying treatment could be devastating.
It is important for nurses to support patients experiencing a stroke. One important thing a nurse must do is support the patient’s airway. The nurse must maintain the prevention of aspiration by doing a swallow evaluation and deferring to speech therapy as needed (,2021). The nurse should also encourage and support mobility, maintain skin integrity, ensure proper communication, and monitor self-care (,2021). By ensuring these needs the nurse can support the patient’s psychological and emotional needs.
Belleza, R. M. N. (2021, October 1). Cerebrovascular Accident (Stroke). Nurseslabs. https://nurseslabs.com/cerebrovascular-accident-stroke/
Falkner, A., & Green, S. (2018). Pathophysiology Clinical Applications for Client Health, Chapter 2, Neurological, Perceptual, and Cognitive Complexities. Grand Canyon University (Ed). https://lc.gcumedia.com/nrs410v/pathophysiology-clinical-applications-for-client-health/v1.1/#/chapter/2
“Emergency care for a patient with a suspected stroke centers around the “time is brain” principle due to the importance of quickly identifying patients with a suspected ischemic stroke to prevent potentially irreversible damage to brain tissue.”
In the emergency department the 3 major signs that alert to stroke are facial, and arm weakness, constant headaches, slurred speech. There are a few other signs that can alert a stroke also. In each hospital that I’ve worked at there is always a protocol in place for patients who’ve suffered, or potentially will suffer from a stroke. Nurses provide quick and responsive services such as rapid medication administration, education, and fall precautions to name a few.
“Nursing care and identification of patient changes is key during this time. Nursing assessments and interventions assist the team in critical decisions related to treatment efficacy and the needs of the patient.”
Updated guidance confirms crucial role of nurses for patients with acute ischemic stroke. American Heart Association. (n.d.). Retrieved July 29, 2022, from https://newsroom.heart.org/news/updated-guidance-confirms-crucial-role-of-nurses-for-patients-with-acute-ischemic-stroke
Nurses have ‘crucial’ role in stroke care, from Ed Admission through discharge. Healio. (n.d.). Retrieved July 29, 2022, from https://www.healio.com/news/neurology/20210311/nurses-have-crucial-role-in-stroke-care-from-ed-admission-through-discharge
When a person has a stroke, it can affect their lives in many ways. The nurse’s role is to support the patient’s psychological and emotional needs. This may include providing information about the stroke, helping the patient adjust to their new reality, and providing support for their family. Nurse’s role is to support the patient’s psychological and emotional needs. This may include providing information about the stroke and helping the patient adjust to their new reality. The most common effects of a stroke are difficulty with communication, mobility, and self-care.
Depending on the severity of the stroke and the regions of the brain that are damaged, a person’s life can be significantly altered in a variety of ways as a result of having a stroke. Stroke victims frequently experience difficulty communicating, moving around, and caring for themselves after the event. Alterations in a person’s state of mind and cognitive processes are also possible. It is possible that the stroke will also affect their families.
It is the responsibility of the nurse to assist the patient in meeting their mental and emotional requirements. This may include educating the patient and family members about the stroke, assisting the patient in adjusting to their new reality, and offering support to the patient’s loved ones.
By informing the patient about the stroke, for instance, a nurse can provide one example of how they can support the psychological needs of a patient. The patient will have a better understanding of what has occurred and what to anticipate as a result of this. The nurse is also able to assist the patient in adjusting to the new circumstances. Providing assistance with things like mobility, communication, and self-care may fall under this category. Additionally, the nurse is able to offer support to the patient’s family. This may include assisting the individual in comprehending the stroke and its effects, offering emotional support, and assisting the individual with matters pertaining to everyday life.
Falkner, A., Green, S. (2018). Neurological, perceptual, and cognitive complexities. In Grand Canyon University (Ed.), Pathophysiology clinical applications for client health. https://lc.gcumedia.com/nrs410v/pathophysiology-clinical-applications-for-client-health/v1.1/#/chapter/2
Lehto, B., Kylmä, J., & Åstedt‐Kurki, P. (2019). Caring Interaction with stroke survivors’ family members—Family members’ and nurses’ perspectives. Journal of Clinical Nursing, 28(1-2), 300-309.
A stroke (cerebral vascular accident) occurs when the blood supply to the brain has stopped. This is due to either a rupturing of the vessel or a blood clot. The part of the brain that is affected, then dies at this point because it cannot get the oxygen it needs. (AHA, 2022). The death of these cells may cause damage to certain parts of the body, leaving deficits and loss of function (Green, 2018). The hallmark signs of a stroke is the acronym FAST (facial drooping, arm drooping, speech, and time)(Green, 2018). Other signs and symptoms of stroke are numbness or weakness of the face or extremities (usually affecting one side of the body), confusion, slurred speech, blurred vision, loss of balance or coordination, and severe headaches.
A stroke can cause an emotional strain on the patient as well as their loved ones. Not only does the patient have to adjust to their new way of life, but the whole family dynamic changes. As nurses we are usually the first ones to the see the patient, so it is our duty to make sure the patient understands what has happened and what is going to happen moving forward. Many stroke patients have a lot of anxiety but a lot of it comes from being scared and not knowing what is going on. It is important that we listen to the patient and show that we care. Also, encouraging the family members to be a part of the patient’s treatment plan moving forward, and connecting them to a social worker who will help them with resources after discharge, is important. Spiritual guidance can be offered by a chaplain who can help assist the patient with any spiritual needs. A nurse can also help the patient and the family develop coping strategies that will help get them through this difficult time in their lives.
American Heart Association. (2022). About stroke. www.stroke.org. Retrieved July 29, 2022, from https://www.stroke.org/en/about-stroke
Falkner, A., & Green, Z.S. (2018). Neurological, perpetual, and cognitive complexities. In Grand Canyon University (Eds.), Pathophysiology Clinical Application for Client Health. https://lc.gcumedia.com/nrs410v/pathophysiology-clinical-applications-for-client-health/v1.1/#/chapter/2