Research Paper on Stroke: A Disease of Widespread Impairment in the US

Introduction

Stroke is a disease that attacks the brain and occurs as a result of the failure of blood to be circulated to an area in the brain. When the brain cells in the part of the brain lack oxygen, they die, and all the activities controlled by that area will be completely impaired. Stroke is a disease that has caused long term disability in many people in the United States of America. It is approximated that each year, 795,000 people suffer a stroke with 600,000 patients being those attacked in the first time, and 185,000 are patients with recurring stroke. Majority of the people who suffer a stroke are those above 65 years (Norrving, 2014).

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Etiology

Before starting treating any disease, it is critical to study the etiology, also referred to as causes of the disease. This helps in avoiding treating the symptoms instead of the disease. The two causes of stroke are blockage of the arteries or bursting of a blood vessel (Bornstein, 2009). Stroke is caused by bursting of the blood vessel while ischemic stroke is caused by blockage of the artery. Approximately 80 percent of all stroke attacks are those caused by narrowing or blockage of arteries. There are two types of ischemic stroke, namely thrombotic stroke and embolic stroke.

A blood clot causes a thrombotic stroke in either of the arteries that supply the brain with blood (Bornstein, 2009). One of the major causes of the clot is fatty deposits that affect the flow of blood. The reduction of the flow of the blood is referred to as atherosclerosis. Embolic stroke is caused by blood clot away from the brain, such as in the heart. The clots are carried to the brain through the blood, thereby affecting all activities carried out by the part of the brain affected.

Pathophysiology Clinical Presentation

Before conducting tests, diagnosis and treatment for a stroke patient, it is essential to understand the pathophysiology of the disease. The patient explains to the nurses or clinical personnel what they feel, and the information obtained formed the basis of testing to establish the disease that the patient is suffering from. If the clinical officer or the nurse understands the way a particular disease affects different organs, they can be able to treat the patient effectively. It is essential to look out for the signs and symptoms of the disease early diagnosis can reduce the damage of the disease on the brain.

One of the common signs of strokes is numbness in the face, arm or leg, and it usually happens on one side of the body (Torbey, & Selim, 2013). Stroke patients suddenly become confused, and vision is impaired. They may be unable to see with one or both eyes, depending on which part of the brain is affected. The patients' mobility is reduced, and they may also feel dizzy. Additionally, the patients have frequent headaches, and the cause cannot be established. As a nurse, once a patient indicates that they have such symptoms, thorough testing should be carried out to come up with the right diagnosis.

Symptoms are not enough reason for diagnosing the patient with stroke because other diseases have the same symptoms. The step is to determine whether the patient is suffering from ischemic or hemorrhagic stroke (Bornstein, 2009). The first test conducted on the patient is the MRI or the CT scan. After the CT scan, the physicians conduct blood tests, carotid ultrasound, and cerebral angiography. An electrocardiogram is also carried out to establish whether the stroke was as a result of heart complications.

To successfully treat the disease, it should be diagnosed at most three hours after the first symptom is seen. This means that urgency is critical to the family members should carry out a simple test to ascertain whether their loved one may be having a stroke. One of the tests is facing the individual and request them to smile (Torbey, & Selim, 2013). If they notice that one side droops there is a need to proceed to the next step which is asking them to raise arms. A person may be unable to raise either of the arms or both. They should also test the speech by asking the person to repeat certain words. If there are any or all the signs, it should be treated as an emergency by calling 9-1-1.

Respiratory Intervention

The function of the respiratory system is affected by stroke significantly. In Hemispheric ischemic strokes, the wall of the chest and diaphragm reduces, thereby impairing the respiratory function (Torbey, & Selim, 2013). A stroke patient may experience difficulty breathing, and the health professionals have the responsibility of coming up with an intervention that effectively boosts the functioning of the respiratory system. One effective intervention is respiratory muscle training an approach which incorporates different types of exercises to improve the lives of stroke survivors.

The weakening of the respiratory muscles impairs the respiratory function of stroke survivors. However, the muscles can be strengthened through respiratory muscle training, coupled with therapeutic exercise (McConnell, 2013). During the training, the patient is asked to sit, relax, and bend the knees, neck and head. They are then requested to place one of the hands-on the chest and the other on the rib cage. The subsequent step is to breathe slowly in a manner that allows the stomach to move outwards. As he/she breaths, they can feel the movement of the diaphragm. Through this exercise, it is important to ensure that stomach muscles are tight and fall inwards while the chest remains still.

Management

Once the clinical professionals carry out tests and diagnose the patient with stroke, they come up with the most effective intervention for managing the disease. The emergency tea should be able to establish the type of stroke that the patient has and the area of the brain that is affected by the disease. As soon as a patient is diagnosed with ischemic stroke doctors wok hastily to restore blood flow to the brain.

One way of managing the disease is through an alteplase injection that is administered to the vein in an arm (Bornstein, 2009). This is an emergency intervention which should be administered not later than four and a half hours after the symptoms of a stroke are seen. The drug dissolves the blood clot, thereby restoring the flow of blood to the brain. However, risks such as bleeding in the brain are considered before deciding whether to use this intervention or not.

Stroke can also be managed by removing the clot and delivering alteplase directly to the area of the brain affected. Also, plaques can be removed from carotid arteries as well as widening an artery that is narrow through a process known as angioplasty (Bornstein, 2009). On the other hand, Hemorrhagic stroke is managed either through endovascular embolization or removing the arteriovenous malformation (AVM). Doctors can also carry out stereotactic radiosurgery as well as surgical clipping. After the medical treatment, patients should be rehabilitated so that they can resume their daily activities.

Outcomes

When the interventions are timely and efficacy based stroke, patients can resume their independent lives within a few months. The patients who receive thrombolysis treatment within three hours get better fast as compared to those whose diagnosis is done late (Bornstein, 2009). After the medical treatment, the patients who undergo rehabilitation resume their daily activities within a few months.

One of the outcomes of stroke is the inability to move one or both of the arms (Norrving, 2014). After the medical treatment, the patients undergo a rehabilitation process, which involves physical therapy through constraint-induced movement therapy, where the patient exercises to train the affected arm. Occupational therapists are involved n helping patients relearn how to undertake daily activities such as cooking. They also undergo speech therapy to help relearn language and psychological therapy to manager emotional challenges such as anger, frustration, and depression.

Conclusion

In conclusion, stroke is one of the leading causes of deaths in the United States of America. Some of the stroke cases are first time attacks, while others are recurring cases. Stroke is caused by blockage of the arteries or bursting of a blood vessel. The two types of stroke are ischemic stroke and Hemorrhagic stroke. Some of the common symptoms are a headache, face, leg or arm numbness, and impaired vision. Patients are advised to treat the symptoms as an emergency because effective treatment is one administered within three hours. The patients are medically and surgically treated, but to ensure that they fully resume the daily activities they have to undergo different kinds of therapy.

References

Bornstein, N. M. (Ed.). (2009). Stroke: A practical guide for clinicians. Karger Medical and Scientific Publishers.

McConnell, A. (2013). Respiratory Muscle Training E-Book: Theory and Practice. Elsevier Health Sciences.

Norrving, B. (Ed.). (2014). Oxford textbook of stroke and cerebrovascular disease. Oxford University Press, USA.

Torbey, M. T., & Selim, M. H. (Eds.). (2013). The stroke book. Cambridge University Press.