Acute Stroke 5 – after 24 hr
Posted On March 8, 2020
Check the following if not already done
- If TPA not given, document reason
- Antiplatelet if not contraindicated.
- Speech, Occupational, Physical therapy
- Lipid checked. Other pertinent lab done.
- High intensity Statin such as Atorvastatin 40-80 mg qd
- Diet
- Deep vein thrombosis prophylaxis
- Document Stroke type/etiology
- Rehab evaluation if indicated, if not document reason
- CTA of head and neck: requires contrast, may not be possible for kidney disease
- MRA head and neck, can be done without contrast, requires patient cooperation, check if pacemaker present
- If above not possible, get carotid doppler
- Cardiac
- Document rhythm, any atrial fibrillation
- TTE, TEE if indicated
- Treatment of underlying medical problem: especially Diabetes, Hypertension
- Patient education including life style modification
- CDC Stroke information
- Print out for patient:
- CDC Stroke information
Prognosis
- NIHSS
- Modified Rankin Scale for Neurologic disability
- Modified SOAR Score for acute stroke: predicts short term mortality
- THRIVE Score for Stroke Outcome: reliable early information about odds of recovery