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Preface
A stroke can happen to anyone at any time. Every year, nearly 800,000 Americans suffer a stroke. Despite improvements in stroke treatment in the United States, stroke remains the second leading cause of death worldwide. Stroke is also the third-leading cause of death and disability combined. Worldwide, the annual rate of stroke is 15 million. Of these, 3 million die and another 3 million are left permanently disabled. Stroke occurs every 40 seconds. Rapid and effective evaluation, identification, diagnosis, and treatment of stroke are vital in decreasing stroke morbidity and mortality.
Source: Critical Care Nursing Clinics of North America - January 2, 2023 Category: Nursing Authors: Wandria Dallas Source Type: research

Invasive Neuromonitoring in the Stroke Patient
With advances in technology, the options to manage patients with neurologic injuries are often complex. Critical care management of neurologic injury has historically focused on the prevention of secondary ischemic injury through aggressive management of intracranial pressure (ICP) and maintenance of adequate cerebral perfusion pressure (CPP). However, ICP monitoring alone does not identify ischemic changes that herald patient deterioration. Advocates of multimodality monitoring cite the value of early detection of changes in brain oxygenation levels and brain metabolism as advantageous in optimizing stroke outcomes. ICP m...
Source: Critical Care Nursing Clinics of North America - January 2, 2023 Category: Nursing Authors: Carey Heck Source Type: research

Nursing Management of Temperature in a Patient with Stroke
Fever is common in patients with stroke and is associated with worse outcomes. Studies in brain injury informed interventions commonly termed therapeutic temperature management (TTM) to improve the monitoring and management of fever. While the role and benefit of TTM in stroke patients has not been well studied, the nurse and healthcare team must extrapolate existing data to determine how to best monitor and apply TTM after stroke. Nurses should be knowledgeable about interventions to monitor and manage complications of TTM (eg, shivering), the studies underway to quantify the impact of fever treatment and emerging technol...
Source: Critical Care Nursing Clinics of North America - January 2, 2023 Category: Nursing Authors: Kristine M. McGlennen, Gemi E. Jannotta, Sarah L. Livesay Source Type: research

Decompressive Hemicraniectomy in the Stroke Patient
Decompressive hemicraniectomy (DHC) is a life-saving procedure involving removal of large portions of the skull to relieve intracranial pressure in patients with space occupying cerebral edema such as traumatic brain injury (TBI) and stroke. Although the procedure has been shown to decrease mortality in patients, the risk of severe disability is significant. Quality of life, not just survival, following DHC has emerged as an important consideration when the decision is made to perform a DHC.
Source: Critical Care Nursing Clinics of North America - January 2, 2023 Category: Nursing Authors: Carey Heck Source Type: research

Strokes and Predictors of Outcomes
Stroke is a leading cause of long-term disability and fifth leading cause of death. Acute ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage, the 3 subtypes of strokes, have varying treatment modalities. Common themes in management advocate for early interventions to reduce morbidity and mortality but not all perception is supported through randomized controlled trials. Each stroke subtype has varying premorbid-related and ictus-related outcome predictive models that have differing sensitivities and specificities.
Source: Critical Care Nursing Clinics of North America - January 2, 2023 Category: Nursing Authors: Shavonne Williams, Kimberly Glaser, Bappaditya Ray Source Type: research

Management of Aspiration Risk in Stroke
Managing risk for aspiration in the stroke patient will assist to decrease one of the major complications that these patients experience, which is poststroke pneumonia. Using an evidenced-based dysphagia protocol is shown to reduce mortality, morbidity, and length of stay caused by poststroke pneumonia. Physicians, nurses, speech pathologists, and dieticians will be instrumental in performing ongoing assessments and aspiration-prevention strategies to improve stroke patient outcome and reduce complications. Education, and measurement of comprehension, of the care team, patient, and family concerning dysphagia management an...
Source: Critical Care Nursing Clinics of North America - January 2, 2023 Category: Nursing Authors: Cynthia Cimini, Shawn Moreau Source Type: research

Theory of Pivoting Uncertainties: Advance Care Planning Among Individuals Living With Mechanical Circulatory Support
CONCLUSIONS: In this sample, patients were ready to share their concerns about the uncertainties of living with MCS and waited for MCS clinicians to initiate ACP. The theory of pivoting uncertainties is useful for elucidating the ebb and flow of ACP and lending clinicians' guidance for opportunities to initiate these sensitive conversations.PMID:36563323 | DOI:10.1097/JCN.0000000000000960
Source: The Journal of Cardiovascular Nursing - December 23, 2022 Category: Nursing Authors: Tiffany Dzou Jo-Ann Eastwood Lynn Doering Carol Pavlish Huibrie Pieters Source Type: research

Effects of a family-focused dyadic psychoeducational intervention for stroke survivors and their family caregivers: a pilot study
Stroke is one of the leading causes of disability in China and worldwide, affecting the health and well-being of both stroke survivors and their family caregivers (i.e. stroke dyads). Dyadic interventions targ...
Source: BMC Nursing - December 21, 2022 Category: Nursing Authors: Huanyu Mou, Stanley Kam Ki Lam and Wai Tong Chien Tags: Research Source Type: research