Case Introduction and FAST Screening – Stroke Nursing Care in ER

by Rhonda Lawes, PhD, RN

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    00:00 So, are you ready? Let's do a case study. Now, the purpose of a case study is for you and I to walk through what it might look like for someone who's experiencing an ischemic stroke. Okay, well, we told you right there in the title, right? This one is an ischemic stroke.

    00:18 So stop for just a minute and see if you can ask yourself, we've talked about 2 types of stroke. One is ischemic, and the other was? Right, hemorrhagic. So I want to introduce you to Mr. Johnson and what it looks like or could look like for a patient at home that experiences an ischemic stroke. So, you've got a picture of Mr. Johnson there.

    00:41 Mr. Johnson was eating breakfast at the table and his wife was in the living room.

    00:45 She heard what sounded like a dish breaking. She asked Mr. Johnson if he was okay, and Mr. Johnson answered slowly.

    00:54 His speech was hard to understand.

    00:56 He didn't seem to make sense. So Mrs. Johnson was understandably concerned, went into the kitchen to check on him, and Mr. Johnson's right arm was hanging down, and his face looked droopy on one side. Okay. Clearly, something is going on. There's some type of event. That's the background of the story.

    01:19 Now, I want you to use the FAST tool, F-A-S-T, to perform a quick assessment on Mr. Johnson.

    01:27 This is a tool that we educate the community to use, so they recognize when a patient needs help.

    01:33 The F stands for facial drooping. That means a section of the face, usually -- usually only on one side that's drooping or hard to move. And it can be recognized if you ask the patient to smile, one side of their face will not be able to smile.

    01:49 Now, think about what you saw with Mr. Johnson. What we just described.

    01:53 Was this positive or not? What about arm weakness? A stands for our weakness, and it's the inability of the patient to raise their arm fully because it is in a weakened state.

    02:06 S stands for speech difficulties. Patient has an inability or it's really difficult for them to understand or to produce speech.

    02:15 And the T is time. If any of those symptoms above are showing, time is of the essence. So it's time to call emergency services or get to the hospital.

    02:27 So now what I want you to do, pause the video, and I want you to go back through and think through all the information that we gave you about Mr. Johnson.

    02:36 Think what Mrs. Johnson observed and what you heard in the story, and write out your own FAST screening for Mr. Johnson.

    02:46 Okay. Welcome back. Now, after walking through that FAST screening, he had several positive signs, so we know the best thing to do is to call 911 and to get him to the ER.

    About the Lecture

    The lecture Case Introduction and FAST Screening – Stroke Nursing Care in ER by Rhonda Lawes, PhD, RN is from the course Neurology Case Study: Nursing Care of Stroke Patient.

    Included Quiz Questions

    1. Facial drooping, arm weakness, speech difficulties, and time
    2. Facial drooping, acute headache, speech difficulties, and time
    3. Facial drooping, arm weakness, seizure, and time
    4. Facial drooping, acute headache, speech difficulties, and tremors
    1. The client should seek immediate medical attention by calling an ambulance.
    2. The client is having a stroke.
    3. The client is having a TIA.
    4. The client has tissue damage and permanent deficits.

    Author of lecture Case Introduction and FAST Screening – Stroke Nursing Care in ER

     Rhonda Lawes, PhD, RN

    Rhonda Lawes, PhD, RN

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