Code Stroke Flashcards
(12 cards)
What symptoms should prompt a Code Stroke activation?
BEFAST – Balance, Eyes, Face droop, Arm weakness, Speech difficulty, Time of onset.
What is the most important time to determine in a stroke?
Last known well time (when the patient was last seen normal).
What initial assessments should the nurse perform in a Code Stroke?
Vital signs, neuro exam (NIHSS if trained), and a blood glucose check.
What gauge IV is preferred for a stroke patient?
18–20 gauge IV, preferably in the antecubital (AC) area.
What labs are typically ordered during a Code Stroke?
CBC, BMP, PT/INR, glucose, troponin, Lactate.
What imaging is urgently required in a stroke workup?
Non-contrast CT head to rule out hemorrhage.
What oxygen goal should be maintained during a stroke code?
Maintain SpO2 ≥ 94%, give supplemental O2 if needed.
Why is the patient kept NPO during a Code Stroke?
To prevent aspiration until a swallow screen is done.
What are the thrombolytics are used for ischemic stroke?
Tenecteplase (TNK), Newer genetically modified version of tPA, mainly used for MI but increased use in stroke due to easier dosing.
Alteplase (tPA), dosed by patient weight. Outdated and not typically used.
What must be ruled out before administering tPA or TNK?
Bleeding risk, recent surgery, high BP, abnormal labs (e.g., INR), or unclear onset time.
What should nurses document during a Code Stroke?
Last known well, time of arrival, CT time, meds given, interventions, and NIHSS score if done.
What communication tool should be used with the stroke team?
SBAR – Situation, Background, Assessment, Recommendation.
