02. Anatomy and Physiology of Stroke

Learning Objective:

2.1 Describes the neuroanatomy and pathophysiology of stroke, including:

  • the different types of stroke and their clinical presentation
  • the cerebral vascular system
  • the organization of the brain’s functions and the associated clinical presentations of right and left hemispheric strokes

Suggested Learning Resources:

Optional Learning Resources:

Apex Innovations (2013). Canadian Hemispheres™ Stroke Competency Series. Level 1 & 2 (Requires paid subscription)

Stars Core Competencies Module 1, 2 & 5

Suggested Evaluation Methods:

Successful completion SWO Acute Stroke Orientation Module 1 Quiz.

OR

Successful completion of Canadian Hemispheres Level 1 &2 Quizzes (Requires Paid Subscription)

OR

Successful completion of Case Studies from Stars Competency 1, 2 & 5

Learning Objective:

2.2 Describes the sudden and new onset of the signs and symptoms of stroke as a medical emergency.

Suggested Learning Resources:

SWO Acute Stroke Unit Orientation Module 3

Suggested Evaluation Methods:

Successful completion of SWO Acute Stroke Unit Orientation Module 3 & quiz.

Learning Objective:

2.3 Describes the clinical presentation and risks associated with transient ischemic attacks and their relationship to stroke.

Suggested Learning Resources:

Heart and Stroke Foundation of Canada, Understanding Transient Ischemic Attack (TIA)

Optional Learning Resources:

Management and outcomes of transient ischemic attacks in Ontario

Canadian Stroke Best Practice Recommendations, TIA and Non-Disabling Stroke

Suggested Evaluation Methods:

List signs & symptoms of TIA/ Stroke.

Identify locations of urgent TIA /Stroke Prevention Clinic in your region.

Learning Objective:

2.4 Differentiates the penumbra and its significance to functional recovery and factors that influence this area including the impact on neurological presentation.

Suggested Learning Resources:

Targeting the Ischemic Penumbra

The Internet Stroke Centre

SWO Stroke Network: Acute Stroke Orientation Module 3

Optional Learning Resources:

Time is Brain –Quantified

Suggested Evaluation Methods:

Provide a brief written summary of your understanding of the penumbra and its significance to timely intervention.

Learning Objective:

2.5 Discusses the rationale for the diagnostic tests used in the assessment and management of stroke and incorporates results as appropriate into the plan of care.

Suggested Learning Resources:

SWO Acute Stroke Orientation Module 4

Suggested Evaluation Methods:

Successful completion of SWO Acute Stroke Orientation Module 4 & quiz.

Review a care plan for an acute stroke client including Pre-Printed Orders (PPO) or order set.

Learning Objective:

2.6 Summarizes discipline-specific standardized assessment tools, and demonstrates the ability to administer the appropriate tools to systematically assess the stroke survivor.

Suggested Learning Resources:

Canadian Stroke Best Practices Screening and Assessment Tools for Acute Stroke Severity

Canadian Stroke Best Practice Recommendations Stroke Rehabilitation Screening and Assessment Tools

Suggested Evaluation Methods:

Identify nursing role with respect to screening/assessment tools being used in your facility.

Create List of Assessments commonly conducted by nurses working in stroke.

Learning Objective:

2.7 Discusses the pathophysiology, clinical presentation and management of secondary stroke complications including

  • Hemorrhagic transformation
  • Reperfusion injury
  • Increased intracranial pressure
  • Cerebral edema
  • Seizures
  • Recurrent Stroke

Suggested Learning Resources:

Inpatient Prevention and Management of Complications following Stroke

SWO Acute Stroke Orientation Module 2

Optional Learning Resources:

Apex Innovations (2013). Canadian Hemispheres™ Stroke Competency Series Level 4 and 5. (Requires Paid Subscription)

Medical Complications of Stroke (Requires Paid Subscription)

Suggested Evaluation Methods:

Succcessful completion of SWO Acute Stroke Orientation module 2 quiz

OR

Successful completion Canadian Hemispheres Level 4 & 5 and quizzes (Requires paid subscription)

Learning Objective:

2.8 Describes the basic pharmacological management of stroke.

Suggested Learning Resources:

SWO Acute Stroke Orientation Module 8

Heart and Stroke: Medications

Optional Learning Resources:

Canadian Stroke Best Practice Recommendations for Acute Stroke Management: Prehospital, Emergency Department, and Acute Inpatient Stroke Care, 6th Edition, Update 2018

Suggested Evaluation Methods:

Successful completion of SWO Acute Stroke Orientation Module 8 Quiz.