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    Transient Ischemic Attack (TIA) : Heart Attack Peripheral Vascular Disease Smoking

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    Princessdhay Tandang
    Transient ischemic attack (TIA), sometimes called a "mini-stroke", is caused by a temporary disruption in blood flow to the brain that lasts less than one hour. Approximately 300,000 TIAs occur in the United States each year and put patients at high risk for future stroke. Symptoms of a TIA include numbness, confusion, vision problems, dizziness and headaches. Risk factors include conditions like heart disease, high blood pressure, diabetes and smoking. Diagnostic tests such as CT scans, carotid ultrasounds and angiograms are used to determine the cause and risk of future stroke. Aggressive treatment of risk factors through medications and lifestyle changes can help prevent further health issues.

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    Transient Ischemic Attack (TIA) : Heart Attack Peripheral Vascular Disease Smoking

    Uploaded by

    Princessdhay Tandang
    20 views3 pages
    Transient ischemic attack (TIA), sometimes called a "mini-stroke", is caused by a temporary disruption in blood flow to the brain that lasts less than one hour. Approximately 300,000 TIAs occur in the United States each year and put patients at high risk for future stroke. Symptoms of a TIA include numbness, confusion, vision problems, dizziness and headaches. Risk factors include conditions like heart disease, high blood pressure, diabetes and smoking. Diagnostic tests such as CT scans, carotid ultrasounds and angiograms are used to determine the cause and risk of future stroke. Aggressive treatment of risk factors through medications and lifestyle changes can help prevent further health issues.

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    Transient ischemic attack (TIA), sometimes called a "mini-stroke", is caused by a temporary disruption in blood flow to the brain that lasts less than one hour. Approximately 300,000 TIAs occur in the United States each year and put patients at high risk for future stroke. Symptoms of a TIA include numbness, confusion, vision problems, dizziness and headaches. Risk factors include conditions like heart disease, high blood pressure, diabetes and smoking. Diagnostic tests such as CT scans, carotid ultrasounds and angiograms are used to determine the cause and risk of future stroke. Aggressive treatment of risk factors through medications and lifestyle changes can help prevent further health issues.

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    20 views3 pages

    Transient Ischemic Attack (TIA) : Heart Attack Peripheral Vascular Disease Smoking

    Uploaded by

    Princessdhay Tandang
    Transient ischemic attack (TIA), sometimes called a "mini-stroke", is caused by a temporary disruption in blood flow to the brain that lasts less than one hour. Approximately 300,000 TIAs occur in the United States each year and put patients at high risk for future stroke. Symptoms of a TIA include numbness, confusion, vision problems, dizziness and headaches. Risk factors include conditions like heart disease, high blood pressure, diabetes and smoking. Diagnostic tests such as CT scans, carotid ultrasounds and angiograms are used to determine the cause and risk of future stroke. Aggressive treatment of risk factors through medications and lifestyle changes can help prevent further health issues.

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    Transient ischemic attack (TIA)

    Introduction

    An estimated 300,000 transient ischemic attacks(TIAs) occur every year. Fifteen percent of all
    stroke patients will have experienced a TIA prior to the stroke. Certain populations are at
    even higher risk for TIA and stroke .Studies show that more than 25 percent of TIA
    patients will have a stroke or other adverse event, ten to 15 percent of TIA patients will return to the
    emergency department with a stroke within 90 days after discharge from the emergency department,
    and half of these occur within three days .

    Transient stroke that lasts only a few minutes. It occurs when the blood supply to part of the brain is briefly interrupted. TIA symptoms, which
    usually occur suddenly, are similar to those of stroke but do not last as long. Most symptoms of a TIA disappear within an hour, although they
    may persist for up to 24 hours.

    Symptoms can include:

    • Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
    • Sudden confusion, trouble speaking or understanding
    • Sudden trouble seeing in one or both eyes
    • Sudden trouble walking, dizziness, loss of balance or coordination
    • Sudden, severe headache with no known cause

    Risk factors for transient ischemic attack (TIA)

    • heart attack (coronary artery disease)


    • peripheral vascular disease
    • family history,
    • smoking,
    • high blood pressure,

    • high cholesterol

    • diabetes.

    Also, any condition that results in stagnant blood flow and or clotting may result in a TIA due to embolization of a blood clot. Such conditions
    may include atrial fibrillation, large heart attacks, and severe weakness of the heart muscle.

    Medical management

    Anti-platelet therapy

    • If the patient was not taking aspirin when the TIA occurred, it needs to be started (325mg per day).

    • If the patient was taking aspirin, then another anti-platelet drug called dipyridamole needs to be added. Aggrenox is a combination of
    aspirin and dipyridamole.

    • If the patient cannot tolerate aspirin, then clopidogrel (Plavix) should be used.

    High blood pressure therapy

    • Even if the patient does not have hypertension or high blood pressure, there may be benefit in taking anti-hypertensive medications.

    • Two classes of drugs are recommended to be started at the same time, a diuretic and an ACE inhibitor.

    • The goal for normal blood pressure is 120/80.

    Cholesterol lowering therapy

    • Guidelines recommend that a statin drug be started, even if cholesterol levels are normal.
    Risk modification

    Smoking, excessive alcohol, obesity and lack of physical activity are considered risks for future stroke. The following recommendations are now
    suggested:

    • Smoking: Counseling, smoking cessation aids like nicotine gum or medications like varenicline (Chantix) should be considered.
    Environmental smoke should be avoided.

    • Alcohol: Intake should be limited to two or fewer drinks a day for men and one or less for women.

    • Obesity: Overweight people should try to lose weight using a combination of diet, exercise and counseling. The goal is a BMI of 18.5-
    24.9 and a waist line of 35 inches or less for women and 40 inches or less for men.

    • Exercise: 30minutes of moderate exercise daily is recommended for those who are able. For patients with disabilities, a tailored
    exercise program to their capabilities should be arranged.

    Diagnostic test

    • Assess mental status to make certain the patient is alert and oriented.

    • Check eye range of motion and facial movement to evaluate the cranial nerves (the short nerves that run from the brain to the face and
    neck).

    • Listen to the neck with a stethoscope to detect abnormal sounds that may signal narrowing of the blood vessel (carotid bruits).

    • Check for a regular heart rhythm to rule out the presence of atrial fibrillation.

    • Examine the arms and legs for tone, power, and sensation.

    • Check coordination and balance.

    Diagnostic Procedure

    If the diagnosis of TIA is made, further urgent testing is usually recommended, including:

    • Electrocardiogram (EKG) to confirm a regular heart rate

    • Computerized tomography (CT scan) of the brain to look for bleeding

    • Carotid ultrasound to look for narrowing of the large blood vessels in the neck

    • Routine blood tests may include a complete blood count (CBC) to look for anemia or low red blood cell count or too few platelets
    (thrombocytopenia). If the patient takes warfarin (Coumadin), a blood thinner, then an international normalized ratio (INR - a blood test
    that measures the degree of blood thinning) or prothrombin time (PT), may be performed to assess blood clotting measurements.

    • If there is concern that the heart is the source of blood clot or debris, then an echocardiogram or sound wave tracing of the heart may
    be considered.
    • Angiography (arteriography or arteriogram). This test is like a cardiac catheterization, only the catheter is placed in the arteries of the
    brain rather than in the arteries of the heart. In this test, a special dye is injected into the blood vessels and an X-ray is taken.

    Angiography gives a picture of the blood flow through the vessels. This allows the size and location of blockages to be evaluated. This
    test can be especially valuable in diagnosing aneurysms and malformed blood vessels and providing information before surgery.

    Three Prioritized Nursing Problems

    Impaired Physical Mobility R/T Hemiparesis

    Ineffective Tissue Perfusion R/T impaired transport of the O2 across alveolar and capillary membrane

    Self Care Deficit(bathing hygiene, toileting dressing, grooming, and feeding ) r/t Stroke sequelae.

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