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Patient Care & Medications

 

Frederick Memorial Hospital has chosen to be a leader in the field of stroke care. FMH has a number of ways to diagnose and treat a stroke. Always ask your nurse if you have questions or would like more information, our nurses are knowledgeable and willing to take the time to help. Some of the protocols, medications and tests the team may use to effectively treat your stroke are discussed below.

The goal of  treatment is to recover as much function as possible and prevent future strokes. Depending on the symptoms, rehabilitation can include speech therapy, occupational therapy and/or physical therapy. Recovery times will differ from person to person.

Certain therapies, such as repositioning and range-of-motion exercises, are intended to prevent complications related to stroke, like infections and bed sores. People should stay active within their physical limitations. Sometimes, urinary catheterization or bladder/bowel control programs may be needed to control incontinence.

The person's safety must be considered. Some people with stroke appear to have no awareness of their surroundings on the affected side. Others show indifference or lack of judgment, which increases the need for safety precautions. For these patients, friends and family members should repeatedly reinforce important information, like name, age, date, time and where they live, to help the person stay oriented.


Medications

  1. Tissue plasminogen activator (t-PA) is a clot busting drug that can marginalize or eliminate the effects of an acute ischemic stroke.  t-Pa needs to be given within 3 hours of time the person was last known or seen well. 
  2. Anticoagulant (AN-tie-ko-ag-u-lant) Agents, also known as “blood thinners,” delay the clotting of the blood.  Two examples are Heparin and Coumadin (warfarin).  You will need to have your blood tested on a normal basis if placed on these medications.  If taking these medications, you should notify your doctor if any of the following occur:
    1. Pink or red-tinged urine
    2. Stools become red, dark brown or black
    3. Bleeding increases during your period
    4. Bleeding gums
    5. You have a very bead headache or you stomach hurts and the pain does not go away
    6. You feel sick or weak, faint or dizzy
    7. You think you may be pregnant
    8. Bruising or blood blisters
    9. You have an accident of any kind (like a fall or car accident)
  3. Antiplatelet (An-tie-plate-let) Agents (like Aspirin) reduce or prevent the occurrence in the bloodstream known as platelet aggregation.  This occurs when a large number of platelets clump together, essentially creating one large clot that could become lodged in one of the vessels in the brain, causing a stroke. 
  4. Antihypertensive medications reduce a person’s blood pressure.  By reducing blood pressure, you reduce the risk of stroke.
  5. Cholesterol lowering medication may also be used if a person’s cholesterol is too high.

Remember to always follow your doctor’s advice when taking any medication. Altering your medication regimen on your own could have serious consequences, including death. If you have any questions about your medication, consult your physician as soon as you can.

Try to have a list of your medications with you at all times. A typed list (including the date the list was typed) is the best way to communicate with other healthcare providers what medications you are taking. The list should detail all of your medications, including supplements, such as vitamins and minerals, the dose, and time taken each day. Keep a copy of the list in your wallet or purse. Make an effort to include your family members or caregivers in your care by providing them a list. An accurate, up-to-date medication list could make a life-saving difference during a medical emergency by providing healthcare providers important information. 


Diagnostic Tests

  1. Head CT or Head MRI -- used to determine if the stroke was caused by bleeding (hemorrhage) or other lesions and to define the location and extent of the stroke.
  2. ECG (electrocardiogram) -- used to diagnose underlying heart disorders.
  3. Echocardiogram -- used if the cause may be an embolus (blood clot) from the heart.
  4. Carotid duplex (a type of ultrasound) -- used if the cause may be carotid artery stenosis (narrowing of the major blood vessels supplying blood to the brain).
  5. Heart monitor -- worn while in the hospital or as an outpatient to determine if a heart arrhythmia (like atrial fibrillation) may be responsible for your stroke.
  6. Cerebral (head) angiography -- may be done so that the doctor can identify the blood vessel responsible for the stroke. Mainly used if surgery is being considered.
  7. Blood work may be done to exclude immune conditions or abnormal clotting of the blood that can lead to clot formation.

 

Time is critical when you or someone you know is having a Stroke.  Call 911 if you think you're having a stroke.

Act F.A.S.T.

 F ace  facial droop and uneven smile
 A rm  arm numbness and arm weakness
 S peech  slurred speech, difficulty speaking or understanding
 T ime  Call 911 and get to the hospital immediately
 

                   

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