Stroke (CVA)
Sudden loss of brain function from impaired cerebral blood flow
Definition
A stroke (cerebrovascular accident, CVA) is the sudden disruption of blood flow to the brain, causing neurologic deficits. It may be ischemic (87%, from clot) or hemorrhagic (13%, from bleeding).
FAST Recognition
- F: Facial drooping
- A: Arm weakness
- S: Speech difficulty
- T: Time. Call 911 immediately
Acute Management
- Ischemic: tPA within 4.5 hours of symptom onset (if no contraindications); mechanical thrombectomy up to 24 hours
- Hemorrhagic: stop bleeding, control BP, possible surgery; NO tPA
- CT scan first to differentiate ischemic vs hemorrhagic
Nursing Interventions
ABCs, NPO until swallow screen, HOB 30° (unless hemorrhagic; flat), neurologic checks every 15 to 60 minutes, BP control per stroke type, DVT prevention, rehab referral, aspiration precautions. Stroke education: FAST and call 911.
NCLEX Relevance
FAST recognition. tPA time window. CT before tPA.