Background and Relevance It is estimated that there are 62,000 strokes in Canada each year and 405,000 of the Canadian population have been living with the effects of a stroke themselves or have a close family member/friend who had suffered a stroke (Heart & Stroke Foundation, 2016). According to the Heart and Stroke Foundation (2016) 16 out of every 100 patients who has suffered a stroke without a past history of dementia, will more than likely develop dementia after their first or recurrent stroke. Working in the Integrated Stroke Unit, patients hospitalized for stroke who also have dementia required quite a lot of complex care, which is understandable, as according to the Canadian Institute for Heath Information, stroke patients with dementia are are at a much greater risk of dying than those without dementia, with a mortality rate of 20% compared to 13% for patient who only suffered a stroke (Heart and Stroke Foundation, 2016).
The stroke recovery process is quite complex, and further issues may develop for a stroke patient with dementia such as a urinary tract infection, which is relatively common in patients who suffered a stroke due to urinary retention or incontinence (American Heart Association/American Stroke Association, 2007). Bacteremia or sepsis is a potential complication of urinary tract infection, and through nursing assessments, if a patient develops a fever after a stoke while in hospital, screening of the urine for evidence of infection should be
Urinary incontinence is very common following a stroke with 40-60% of hospitalised patients experiencing it in the acute phase, 25% on discharge and one third of survivors experiencing ongoing problems at one year (Barrett 2002, Kolominsky-Rabas et al.2003).Bladder and bowel problems are common following a stroke and can have a huge impact on physical and psychological aspects of quality of life, for both patients and carers. Health care professionals can do much to help improve and manage incontinence problems in stroke patients and this starts with a good understanding of key issues. Mobility and manual dexterity problems can compound bladder and bowel symptoms because they can make toileting access difficult, other problems such as visual disturbances, dysphagia and cognition also contribute indirectly to continence difficulties. There is evidence that professional input through structured assessment and management of care, together with the involvement of specialist continence nursing services, may reduce urinary incontinence and related symptoms after stroke. Bladder and bowel care requires active management –this includes a written personalised plan, taking into consideration required assistance, personal needs and goals. This essay is an overview on the importance of timely nursing assessment and management of urinary incontinence
You may have questions about sexual activity after a stroke. Stroke causes physical and emotional changes. This may include physical changes that affect your ability to have sex. You may also go through emotional changes that affect your desire to have sex.
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
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
Stroke is a leading health care problem worldwide; ‘living with stroke’ is a real challenge both stroke survivors and their caregivers face.
According to the Alzheimer Society of Canada (2017), there are roughly over half a million Canadians currently living with dementia, and 25,000 new cases are diagnosed each year. Although the hallmark presentation of dementia is progressive cognitive impairment, perhaps the most
Post stroke patients ' therapy process passively, done by following the movement of the arm exoskeleton that is driven automatically based on programs that have been created. The movement of the exoskeleton of the machine can be programmed to perform the movement fleksi and extension with a specific speed and angle position. Setting the speed of motion and position of this angle can be set using the PWM (pulse width
In almost all cases of dementia, stroke is the main pre-cause towards this disease. The first thing to prevent this disease will be to understand what a stroke is and how to prevent it from occurring, although some cases in which a stroke surfaced, the subject was not at risk of any symptoms for a stroke, so it can be a guessing game. Seizures, hypotension and urinary incontinence are the three strongest predictive signs of post stroke dementia. Scientists use a new predictive theory to lay down a concrete analysis on whether or not a patient is at risk for post-stroke dementia. In summary, a stroke is associated with an increased risk of dementia. “About 1-in-10 patients are demented prior to first stroke, 1-in-10 develop new dementia soon after first stroke, and over 1-in-3 are demented after a recurrent stroke.” The number one pre-stroke dementia care factor is optimal acute stroke care and prevention of recurrent stroke are likely to be effective in slowing the pain of post-stroke
The over the counter medication once known only for its ability of easing aches and pains or fighting off fever and inflammation is proving itself to be quite the miracle drug. Aspirin has become part of the protocol for stroke victims as a preventative measure due to its neuro-protective benefits. Stroke can cause lesions in cerebral white matter, which may result in cognitive impairments such as deficits in learning and memory. White matter lesions (WML) have also been linked to increasing the risk of post-stroke dementia. Cerebral white matter damage has been widely overlooked. Comprised of oligodendrocytes that form the insulating myelin in the CNS, white matter is evidentially just as vulnerable to ischemia as gray matter.
This reflection case study will be discussing urinary continence management using Gibbs reflective framework (Gibbs,1988). This will include what is urinary incontinence management, the pathophysiology of urinary incontinence after stroke, how continence affect patient and current clinical practice and the role of the nurse and multi-disciplinary team within continence management. Also using the evidence based research and national guidelines.
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.
Dementia is a disease that does not discriminate against gender, race, or nationality. It affects individuals, their families, and caregivers each day by testing their strength and patience. Within the category of dementia there is a subtype called Multi-Infarct Dementia. MID is a disease that affects around 30% of individuals over the age of sixty-five (Al-Adawi, 2014). The individuals with MID have damage to their brain which causes many different symptoms to occur. When the symptoms are noticed, the specific type of dementia may be hard to diagnose, and the treatments cannot reverse brain damage. As MID progresses, the individual’s cognitive functions deteriorate, so the care and patience these individuals once shared with others will have
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.,
Evidence-Base practice (EBP) is defined as based on problems identified from nursing practice; using best evidence and professional expertise and merging them into current practice to ensure patients receive quality care (French, 1999). Evidence-based practice is a part of quality improvement process; it is made of evidence, clinical expertise, patient preference and the context of care (Barker, 2013). In brief, evidence-based practice is the guideline in the nursing practice that requires nurses gather and use clinical evidence to help diagnose or assess patients correctly by using their knowledge and experience in order they can deliver the quality of care to the patients (Ellis, 2013). In the other words, in the nursing practice the clinical evidence supports all the nursing procedures performed.
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