Acute Stroke Nursing / Edition 1

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Stroke is a medical emergency that requires immediate medical attention. With active and efficient nursing management in the initial hours after stroke onset and throughout subsequent care, effective recovery and rehabilitation is increased. Acute Stroke Nursing provides a current, evidence-based, practical text facilitating the provision of optimal stroke care during the primary prevention, acute and continuing care phases.

This timely, comprehensive and practical text is structured to follow the acute stroke pathway experienced by patient. It explores the causes, symptoms and effects of stroke, and provides guidance on issues such as nutrition, continence, positioning, mobility and carer support.

The text also considers rehabilitation, discharge planning, palliative care and the role of the nurse within the multi-professional team. Acute Stroke Nursing is the definitive reference on acute stroke for all nurses and health care professionals wishing to extend their knowledge of stroke nursing.

Evidence-based and practical in style, with case studies and practice examples throughout

Edited and authored by recognized stroke nursing experts, clinicians and leaders in the field of nursing practice, research and education

The first text to explore stroke management from UK and international perspectives, and with a nursing focus

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Editorial Reviews

From the Publisher
"Although aimed at acute stroke services, this book provides a good basis for members of the multidisciplinary team, especially all medical and neuroscience nurses . . . This book will be applicable to healthcare professionals for many years." (Primary Health Care, 1 July 2011)

"This will certainly be the first place I turn for future stroke-related technique." (Nursing Older People, 1 November 2010)

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Product Details

  • ISBN-13: 9781405161046
  • Publisher: Wiley
  • Publication date: 4/19/2010
  • Edition number: 1
  • Pages: 368
  • Product dimensions: 7.40 (w) x 9.60 (h) x 1.00 (d)

Meet the Author

Jane Williams is Consultant Nurse in Stroke Care, based in Portsmouth Hospitals NHS Trust, UK. She has been involved in many national working parties, including the National Stroke Strategy, UK Forum for Stroke Training, and UK Stroke Forum. Jane is member of The Stroke Association research awards committee. A founder member of the National Stroke Nursing Forum, Jane undertook a term of office as chair.

Lin Perry is Professor of Nursing Research and Practice Development, University of Technology, Sydney and the Northern Hospitals Network, South Eastern Sydney and Illawarra Area Health Service. A member of the Intercollegiate Stroke Working Party in the UK, the National Stroke Foundation Guidelines Working Party and Stroke Services New South Wales in Australia, she has extensive experience with national guideline development, benchmarking, service review and evaluation.

Caroline Watkins is Professor of Stroke and Older People's Care at the University of Central Lancashire, UK. As a member of the Vascular Team at the Department of Health, she is working to implement the National Stroke Strategy, and leads the development of the new UK Forum for Stroke Training. Caroline is the president of the Society for Research in Rehabilitation and on the Steering Group of the National Stroke Nursing Forum.

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Table of Contents

Foreword vii

Editors and Contributors xiii

1 Setting the scene Caroline Watkins Michael Leathley 1

Introduction 1

Stroke epidemiology 2

Stroke policy 3

Stroke management strategies 8

Research and education 11

Conclusion 13

References 13

2 Developing stroke services: a key role for nursing and nurses Christopher R. Burton 17

Introduction 17

Service development 17

The nursing contribution to stroke services 19

The political agenda shaping stroke service development 25

Conclusion 30

References 30

3 What is a stroke? Anne W. Alexandrov 33

Introduction 33

Stroke development processes 34

Risk factors for stroke 37

Anatomy, physiology and related stroke clinical findings 37

Standardised instruments for acute neurological assessment 57

Conclusion 60

References 64

4 Acute stroke nursing management Anne W. Alexandrov 66

Introduction 67

Priorities in acute stroke management 67

Hyperacute stroke management 68

Acute stroke management 80

Conclusion 85

References 85

5 Nutritional aspects of stroke care Lin Perry Elizabeth Boaden 91

Introduction 92

Do stroke patients experience nutritional problems pre-stroke? 92

How does stroke affect dietary intake? 95

How can stroke patients be helped to maintain adequate dietary intake? 104

Conclusion 115

References 117

6 Promoting continence Kathryn Getliffe Wendy Brooks 123

Introduction 124

Bladder problems and urinary incontinence 127

Bowel problems and bowel care 144

Conclusion 148

References 149

7 Management of physical impairments post-stroke Cherry Kilbride Rosie Kneafsey 152

Introduction 153

Movement 153

Moving and handling people with stroke 155

Therapeutic positioning and seating in the acute phase 157

Promoting early mobilization 159

Falls prevention 163

Restoration and re-education of movement 164

Management of the upper limb 168

Further rehabilitation strategies and novel developments 171

Patients' perspective on mobility rehabilitation 174

Conclusion 175

References 176

8 Communication Jane Marshall Katerina Hilari Madeline Cruice 184

Introduction 185

Communication impairments caused by stroke 186

Language minorities 196

The role of the speech and language therapist in acute stroke care 197

Psychosocial issues and quality of life 199

Conclusion 201

References 201

9 Mood and behavioural changes Peter Knapp 205

Introduction 205

Psychological reactions to the onset of stroke 206

Conclusion 218

References 219

10 Minimally responsive stroke patients Elaine Pierce Aeron Ginnelly 222

Introduction 222

Definitions and identification 223

Minimally responsive state 224

'Locked-in' syndrome 232

Conclusion 237

References 238

11 Rehabilitation and recovery processes Jane Williams Julie Pryor 241

Introduction 241

Initiation of rehabilitation 244

Outcomes of rehabilitation 246

Recovery processes 249

Transfer to rehabilitation 250

Rehabilitation provision 252

Conclusion 256

References 256

12 Stroke and palliative care: a difficult combination? Christopher R. Burton Sheila Payne 263

Introduction 264

Palliative care 264

Relevance of palliative care to stroke 266

Organisational challenges 271

Conclusion 271

References 272

13 Reducing the risk of stroke Peter Humphrey Jo Gibson Stephanie Jones 275

Introduction 275

Primary prevention 276

Secondary prevention: identifying those at risk of stroke 279

Public awareness and access to services 296

Secondary prevention of stroke in less common aetiologies and patient groups 297

Conclusion 299

References 299

14 Longer-term support for survivors and supporters Louise Brereton Jill Manthorpe 309

Introduction 309

Leaving hospital 310

What is required longer term? 313

What do carers want? 316

Conclusion 322

References 323

15 Stroke resources for professionals, patients and carers Graham Williamson 331

National associations 331

Resources for patients and carers 332

Other resources and organizations 333

Specialist international journals 336

Non-specialist journals' stroke collections 336

Clinical practice guidelines 337

Finding current stroke research 338

Evidence-based practice resources 338

Chapter links 339

Index 343

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