Update on Transient Ischemic Attack Nursing Care
Considered a medical emergency, a transient ischemic attack (TIA) resulting from a focal ischemia in the brain or retina signals a sudden neurological deficit with patient symptoms typically lasting only 1 to 2 hours.1,2 The 90-day risk of stroke after a TIA is reported as high as 17% with the highest risk occurring in the first week.3,4 Approximately 240 000 US adults each year experience a TIA.5 The true prevalence of TIAs seems under-reported because patients fail to report their symptoms to healthcare providers.6,7 Evidence supports when an individual is at risk for TIA or one is suspected, immediate action is required.
Nurses play a pivotal role in all phases of patient care. Also, they frequently are on the front line regarding TIA and stroke education of patients/families, recognition of signs/symptoms, assessment and evaluation of modifiable risk factors, and long-term management of TIA.7–9 The purpose of this article is to provide an update of the most salient aspects of evidence-based TIA nursing care.
Nurses especially with advance practice training have a unique role in the initial evaluation (eg, identifying symptoms, eliminating mimics, triaging TIA referrals or early access to initial evaluation, assessing risk of acute and long-term complications), diagnosis, management, and patient/family education.7,9 Evidence resulting from a 5-year prospective study reveals key clinical characteristics associated with an impending stroke which include first diagnosis of TIA, increased age, deficits lasting >10 minutes, history of gait disturbance, dysarthria, elevated blood pressure …