Download Recovering from Your Stroke

Patient Education
CONDITIONS AND DISEASES
Recovering from Your Stroke
Stroke
If you have any
A stroke is a brain injury caused by decreased blood flow to the
brain. This occurs when a blood vessel in or around the brain is
blocked or ruptures. As a result, the brain does not get needed
oxygen and nutrients. Stroke symptoms and recovery time vary,
depending on the area and extent of the brain injury.
questions or
This information describes what stroke patients can expect during
their hospital stay:
concerns, please
ask your doctor
or nurse.
Life on the Neuroscience Unit.................... 1
Tests........................................................... 3
Neuroscience Units.................................... 3
Other Helpful Information......................... 4
Hospital Services........................................ 4
After Hospital Care..................................... 6
The Stroke Team......................................... 7
Life on the Neuroscience Unit
The Neuroscience Unit is staffed by a team of specialists, including:
■ Doctors.
■ Dietitians.
■ Nurses.
■ Occupational therapists.
■ Speech therapists.
■ Social workers.
■ Physical therapists.
■ Chaplains.
They work together to help stroke patients and their families get back to normal living as
soon as possible.
When you first arrive on the unit, you will note that the bed is higher and more narrow than
the one in your home. There are side rails to protect you while you are sleeping. Please do
not try to raise or lower the rails yourself. Each bed has a call button to push when you need
a nurse.
Be sure to tell your doctor what medicines you are taking, including any herbal supplements
and home remedies. Do not take medicines from home. Needed medicines are given and
explained to you.
Some stroke patients have trouble talking. The nurse will:
■ Work with you to devise ways to help you communicate.
■ Show you how to use the nurse call button.
While in the unit, you will be connected to a heart monitor. A pulse oximeter clips to
your finger to monitor your blood oxygen level. This tells us if you need additional
oxygen. Your vital signs (blood pressure, heart rate, breathing and temperature) are
checked often. The nurse also will perform neurologic exams. This involves checking your
senses, including:
■ Speech.
■ Movement and feeling in your face, arms and legs.
■ Sight.
■ How well you understand (spoken word).
Also, your fluid intake and urine output are measured.
Medicines and fluids are given through IV (into the vein) lines.
Deep Vein Thrombosis (DVT)
While you are in the hospital, steps will be taken to prevent blood clots from forming in
your legs. These steps may include:
■ Low-dose “blood-thinning” medicines.
■ DVT Prevention boots. These boots gently squeeze your calves to promote blood
flow to the heart. It is important to wear these boots while you are in bed and in the
chair.
Swallowing
At first, some stroke patients have trouble swallowing. Your ability to swallow must be
checked before you can eat or drink anything. This is to prevent food or liquids from
getting into your lungs (aspiration pneumonia).
First, your nurse will do a bedside swallow screening test. Then, if needed, a speech
therapist tests to see:
■ If you can eat.
■ What foods are the safest.
Diet
When you are able to eat:
■ A food service hostess will visit each day to help you select your food items.
■ You will be on a diet low in salt, fat and cholesterol. If your family plans to bring you
food, talk with a dietitian. (This food can be kept in the pantry refrigerator. It must be
labeled with your name, room number and date. All foods must be discarded after
3 days. There also is a microwave in the pantry.)
You must sit fully upright to eat, unless told otherwise by your speech therapist. As
needed, the nursing staff can assist you to eat. Do not let your family feed you unless
shown by a speech therapist. These safeguards are in place to help prevent pneumonia.
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If you have trouble swallowing, the doctor may insert a small tube that is put in the nose
and down into your stomach. Food and medicines are given through the tube. The tube
is left in place for a short time. If you need more time to regain your swallow, the doctor
will talk with you about other ways for you to get the nutrition you need. The speech
therapist works with you to strengthen the “swallowing” muscles.
Activity
For the first day or two, most patients are on bedrest. The nurse will help you use the
bedpan (or bedside commode, if allowed).
Always ask your nurse for help when walking to the bathroom or in the hallways. Unless
instructed otherwise, do not get out of bed by yourself.
Tests
Along with routine lab tests, your blood sugar level is often checked before meals and at
bedtime (even if you are not a diabetic). Other tests may be done to:
■ Find the cause of your stroke.
■ Help the doctors decide on the best treatment options based on your needs.
These tests may include:
■ Swallow test.
■ CT scan of your head.
■ Chest X-ray.
■ Electrocardiogram.
■ MRI/A (magnetic resonance imaging/angiography) of your brain.
■ Ultrasound of the blood vessels of your neck (carotid Doppler).
■ Ultrasound of your heart (echocardiogram).
Your doctor and nurse will prepare you for and explain these tests.
Neuroscience Units
Most patients spend the first 2 days on the Specialty Neuroscience Unit. Your stay varies
based on your condition. Once your condition is stable, you are moved to a general care
neuroscience unit.
■ The heart monitor may be removed when you transfer to a general care unit.
■ Your vital signs and your blood oxygen level are checked, but not as often.
■ The Stroke Team will help you return to your normal activities.
Here you will continue to work with a physical therapist to gain strength. If needed,
other therapists will help you to speak and to perform basic skills by yourself, such as:
■ Eating.
■ Bathing.
■ Dressing.
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It is important to follow your exercise guidelines. Your family is asked to help with your
therapies. They are an important part of your recovery.
A dietitian may visit to explain any specific diet guidelines. These may include:
■ A low-salt diet to prevent fluid build-up.
■ Limiting the fluids you drink.
■ A low-fat, low-cholesterol diet.
Other Helpful Information
Valuables
Please send all valuables home or ask to store them in the safe in your room. The
hospital is not responsible for the loss of money, jewelry or other belongings.
Be sure to put your dentures, hearing aids and glasses in a safe place after you use them.
Telephones
While you are in the hospital, you will have your own private telephone. Please tell your
family and friends your number and extension. At any time, your family may call the
nurses’ station to ask about you:
■ Specialty Neuroscience Unit: 312-926-5169.
■ General Care Neuroscience Unit: 312-926-3439.
To protect your privacy, the nurse may share only limited information about your condition.
It is helpful to select one person to be the primary contact to receive information.
Alcohol and Smoking
Patients may not drink alcohol.
Northwestern Memorial Hospital is a smoke-free environment. No one may smoke in
any part of the hospital.
Visitors
■ Early in your recovery, you will need rest periods during the day. To provide rest
periods, your nurse will work with you to plan your daily schedule. Then, please tell
your family and friends when the best times are to call or visit.
■ Children under 12 may not visit on the unit unless given an okay by the clinical nurse
coordinator or the unit manager.
■ We ask that no more than 2 family members visit at one time.
■ If you have any questions or concerns, please talk to a staff member.
Hospital Services
Reading Materials
Volunteers wear maroon-colored lab jackets, and are here to help you and the hospital
staff. They may bring mail, books, magazines, and cards to help brighten your day. Ask
your nurse for help or call the Volunteer Services directly at 6-2070, Monday through
Friday between 8:00 a.m. and 4:30 p.m. to request their services.
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Books, magazines and newspapers are also available at Barbara’s Bestsellers Bookstore
on the 1st floor of Galter Pavilion. The bookstore is open 7 days a week.
Parking
Parking is available for patients and visitors in the garage at 222 East Huron, across from
the Feinberg and Galter pavilions. For discounted rates, please bring your parking ticket
with you. Tickets can be validated at the Customer Services Desks on the 1st and 2nd
floor of the Feinberg and Galter pavilions.
Lounge/Waiting Area
The family waiting area located just outside the unit offers your family and friends
a place for 2 or more visitors at a time. The lounge can be used during the day and
evening. Please be considerate of other patients and visitors.
Education for Patients and Families
Learning about stroke will aid your recovery and help prevent a future stroke. The members
of the stroke team will be happy to answer any questions. The Video On-Demand system
provides helpful information about how to stay healthy and prevent diseases. Your nurse
also will give you added written information based on your specific needs.
Consider viewing the programs listed below. Just dial 6-2585 on your telephone, select
English or Spanish, and enter the order number when prompted. Listen for, then turn to
the assigned TV channel. Your nurse also can help you use the system.
Order #
Title
Run Time
337
Healthy Eating: Simple methods to choose
healthful foods. (English)
12 minutes
338
Nutricion: Comer Saludablemente Toda La Vida. (Spanish)
163
High Blood Pressure: Methods of controlling
blood pressure. (English)
164
Tension Arterial Alta: Una Introduccion a su
Tratamiento. (Spanish)
339
Smoking: Getting Ready to Quit: Practical and proven
tips to quit smoking. (English)
340
Fumar: Estar Preparado Para Dejar de Fumart. (Spanish)
122
Relaxing through the Seasons: Guides you into a state of
deep relaxation using 5 easy “exercises.” (English only)
33 minutes
157
What is Aphasia?: Learn about impact on verbal and
written skills; ways to cope. (English only)
30 minutes
156
Moving Beyond Stroke and Aphasia: Learn how actual
patients deal with the after-effects of strokes. (English only)
31 minutes
5
13 minutes
16 minutes
After Hospital Care
When leaving the hospital, some patients may go home. Others may need to continue
their recovery in a:
■ Rehabilitation (rehab) center.
■ Extended care facility.
The hospital social worker may help arrange for:
■ Placement in a rehab or extended care facility.
■ Home support, such as:
- Family support or homemaker services.
- Home nursing care.
- Home therapy.
Before discharge, the nurse will review guidelines to reduce your risk of stroke.
■ Lifestyle changes.
■ Medications.
■ Diet.
■ Activity.
■ Follow-up care appointments.
- Rehab (therapy).
- Doctor visits.
- Lab testing.
At Home
If you have any questions or concerns, contact your doctor or the nurses on the
Neuroscience Unit at 312-926-3439.
Call 911 if you have sudden:
■ Weakness, numbness of face, arm, or leg, especially one side more than the other.
■ Confusion, visual changes.
■ Trouble speaking or understanding speech.
■ Dizziness or decreased balance/coordination.
■ Headache with no known cause (etiology).
Your recovery is important to us. Please remember that healing takes time. Be patient.
You are on your way to recovery.
If you or your family have questions, please ask us at any time.
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The Stroke Team
The Stroke Program at Northwestern Memorial Hospital is proud to give you state-ofthe-art care. We want to do everything to help stroke patients and their families get back
to normal living as soon as possible. The Stroke Team works together to provide and
coordinate needed therapies. Of course, you may not need us all. Your nurse or doctor
can tell you which therapies will aid your recovery.
■ Doctors.
Your attending physician, whose specialty is neurology, directs your medical care
while you are on the unit. This doctor also follows your progress closely. If you need
surgery, a neurosurgeon is involved in your care.
■ Nurses.
Your nurses are RNs (registered nurses) trained in caring for stroke patients. They
work with you to set a plan for your nursing care each day. Nurses direct the
Certified Nursing Assistants (CNAs) or Patient Care Technicians (PCTs) to help you
with basic daily needs, such as bathing and dressing.
Other members of the nursing staff you may meet are:
■ The clinical nurse manager or clinical coordinator. They direct the functioning of the
Neuroscience Units.
■ The nurse practitioner, who has extensive training in the area of neuroscience/
stroke. These and other RNs explain your diagnosis, how the team cares for you and
how to care for yourself.
Speech Therapist
As needed, a speech therapist helps you in these areas:
Swallowing
The speech therapist may test you to see how well you can swallow. Some patients may
get an exercise program and special instructions for eating.
Speech
The speech therapist teaches you exercises that help you speak clearly. This may involve
muscles in your jaw, lips, tongue, palate or vocal cords.
Language and Understanding
The speech therapist may help you with one or more of the following:
■ Understanding words.
■ Reading.
■ Speaking clearly.
■ Writing.
Body language: verbal and nonverbal cues such as eye contact, facial expression and
staying on topic. These are the little habits that not only convey what you mean, but
help you be like “your old self ” again.
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If your stroke affected any of the following areas, the speech therapist also may help you
improve:
Memory.
■ Attention.
■
Problem-solving.
■ Calculations.
■
Physical Therapist (PT)
After a stroke, many people lose strength and have trouble with movement. Your PT
works with you to:
■ Strengthen weak muscles.
■ Relearn control of your movements.
■ Make up for areas of weakness.
In therapy, you learn ways to help you move, lift things and walk. The goal is to keep you
safe while you recover.
Occupational Therapist (OT)
Your OT tests your balance and how well you move, see and carry out the tasks of daily
living. (These are the basic skills you need for eating, bathing, dressing and moving to a
chair or toilet.) Your OT may design splints that position and support your hands and feet
while you work to strengthen them. The OT also works closely with both your physical
and speech therapist to help you start to do things on your own.
Pharmacists
The pharmacists work with your doctors and nurses to tailor your medication treatment.
If you are put on “blood-thinning” medicine, the pharmacist from the Anticoagulation
Dosing Service checks your blood levels and adjusts your medicine dose as needed. This
care continues after you are discharged from the hospital.
Social Work
The Stroke Team includes a social worker who works with you, your family and the rest
of the Stroke Team to plan your return to life outside the hospital. You can expect your
social worker to ask you questions about your life before your stroke.
Social workers can help find community resources and prepare you for your discharge
from the hospital. Based on your needs, this may include a stay in a rehabilitation facility.
Your social worker also can help in adjusting to changes and feelings you and your family
may face.
If needed, the social worker helps you and your family receive specific home care
services, such as:
■ Visits by a nurse.
■ Physical or occupational therapy.
■ Medical equipment such as a hospital bed or portable oxygen.
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Dietitian
The registered dietitian is an expert in healthful eating, who knows how diet can help
patients live better and longer. The dietitian checks your weight, your appetite and how
well you can eat. The dietitian may meet with you and your family to review your diet
history and discuss your diet needs.
Pastoral Care
A chaplain will be glad to listen and help with emotional and spiritual needs. If you
would like a visit from a chaplain, simply tell your nurse.
Health Information Resources
For more information, visit Northwestern Memorial Hospital’s Alberto Culver Health Learning Center.
This state-of-the-art health library is located on the 3rd floor of the Galter Pavilion. Health information
professionals are available to help you find the information you need and provide you with personalized
support at no charge. You may contact the Health Learning Center by calling 312-926-LINK (5465) or by
sending an e-mail to [email protected].
For additional information about Northwestern Medicine, please visit our website at nm.org.
Para asistencia en español, por favor llamar al Departamento de Representantes para Pacientes al 312-926-3112.
The entities that come together as Northwestern Medicine are committed to representing the communities we serve, fostering a culture of inclusion, delivering
culturally competent care, providing access to treatment and programs in a nondiscriminatory manner and eliminating healthcare disparities. For questions, please
call either Northwestern Memorial Hospital’s Patient Representatives Department at 312-926-3112, TDD/TTY 312-944-2358 and/or the Northwestern Medical Group
Patient Representatives Department at 312-926-1920, TDD/TTY 312-695-3661.
Developed by: Neuroscience Nursing, the Department of Neurology and the Stroke Team
©October 2014 Northwestern Medicine
For additional information about Northwestern Medicine, please visit our website at nm.org.
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