Ischemic Stroke: NCLEX Priorities
Ischemic stroke: FAST recognition, tPA window, NIHSS, swallow eval before PO.
Ischemic stroke is the majority of strokes. Time-sensitive. NCLEX tests FAST, tPA window, and post-stroke nursing.
FAST recognition
Face droop, Arm weakness, Speech difficulty, Time, call 911.
tPA window
Within 4.5 hours of symptom onset. Some centers extended for select patients. Contraindications: recent surgery, active bleeding, recent stroke, BP >185/110.
Mechanical thrombectomy
Large vessel occlusion. Window up to 24 hours in select patients with imaging-confirmed salvageable tissue.
Post-stroke care
Swallow eval before any PO (aspiration risk). Speech, OT, PT. DVT prophylaxis. Antiplatelet (aspirin) within 24-48h. Statin. BP management. Glucose control.
Secondary prevention
Antiplatelet long-term. AFib: anticoagulation. Carotid endarterectomy if >70% stenosis on symptomatic side.
Frequently asked
BP target after stroke?
Initially permissive HTN (BP <220/120 OK). After 24h or if tPA given: more aggressive control.
Swallow eval, who does?
Speech-language pathologist. RN bedside screen first if available.
Quick check
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