Stroke Nursing
Second Edition
,Stroke Nursing
Second Edition
Edited by
JANE WILLIAMS
Southern Health Foundation Trust
Southampton, UK
LIN PERRY
University of Technology Sydney
Northern Hospitals Network
South Eastern
Sydney Local Health District
Sydney, NSW, Australia
CAROLINE WATKINS
University of Central Lancashire
Preston, UK
,This edition first published 2020
© 2020 by John Wiley & Sons Ltd
Edition History [1e, 2010]
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or
transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or other-
wise, except as permitted by law. Advice on how to obtain permission to reuse material from this title
is available at http://www.wiley.com/go/permissions.
The right of Jane Williams, Lin Perry, and Caroline Watkins to be identified as the author of editorial
in this work has been asserted in accordance with law.
Registered Office(s)
John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, USA
John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK
Editorial Office
9600 Garsington Road, Oxford, OX4 2DQ, UK
For details of our global editorial offices, customer services, and more information about Wiley prod-
ucts visit us at www.wiley.com.
Wiley also publishes its books in a variety of electronic formats and by print‐on‐demand. Some content
that appears in standard print versions of this book may not be available in other formats.
Limit of Liability/Disclaimer of Warranty: The contents of this work are intended to further general
scientific research, understanding, and discussion only and are not intended and should not be relied
upon as recommending or promoting scientific method, diagnosis, or treatment by physicians for any
particular patient. In view of ongoing research, equipment modifications, changes in governmental
regulations, and the constant flow of information relating to the use of medicines, equipment, and
devices, the reader is urged to review and evaluate the information provided in the package insert
or instructions for each medicine, equipment, or device for, among other things, any changes in the
instructions or indication of usage and for added warnings and precautions. While the publisher and
authors have used their best efforts in preparing this work, they make no representations or warran-
ties with respect to the accuracy or completeness of the contents of this work and specifically disclaim
all warranties, including without limitation any implied warranties of merchantability or fitness for
a particular purpose. No warranty may be created or extended by sales representatives, written sales
materials or promotional statements for this work. The fact that an organization, website, or product
is referred to in this work as a citation and/or potential source of further information does not mean
that the publisher and authors endorse the information or services the organization, website, or prod-
uct may provide or recommendations it may make. This work is sold with the understanding that the
publisher is not engaged in rendering professional services. The advice and strategies contained herein
may not be suitable for your situation. You should consult with a specialist where appropriate. Further,
readers should be aware that websites listed in this work may have changed or disappeared between
when this work was written and when it is read. Neither the publisher nor authors shall be liable for
any loss of profit or any other commercial damages, including but not limited to special, incidental,
consequential, or other damages.
Library of Congress Cataloging‐in‐Publication Data
Names: Williams, Jane (Jane E.), editor. | Perry, Lin, editor. | Watkins, Caroline, editor.
Title: Stroke nursing / edited by Jane Williams, Lin Perry, Caroline Watkins.
Other titles: Acute stroke nursing
Description: Second edition. | Hoboken, NJ : Wiley-Blackwell, 2019. | Preceded by: Acute stroke
nursing / edited by Jane Williams, Lin Perry, Caroline Watkins. 2010. | Includes bibliographical
references and index. | Identifiers: LCCN 2018054706 (print) | LCCN 2018057605 (ebook) |
ISBN 9781119111467 (AdobePDF) | ISBN 9781119111474 (ePub) | ISBN 9781119111450 (pbk.)
Subjects: | MESH: Stroke–nursing | Evidence-Based Nursing
Classification: LCC RC388.5 (ebook) | LCC RC388.5 (print) | NLM WY 152.5 | DDC 616.8/10231–dc23
LC record available at https://lccn.loc.gov/2018054706
Cover Design: Wiley
Cover Image: © KTSDESIGN/SCIENCE PHOTO LIBRARY/Getty Images
Set in 10/12pt Stix by SPi Global, Pondicherry, India
10 9 8 7 6 5 4 3 2 1
, Contents
E D I TO RS A N D CO N T R IB UTO RS ix
FOREWO R D : ST R O K E N URS IN G xiii
FOREWO R D : ST R O K E S ERVIC ES IN AUST RA L IA xv
FOREWO R D : ST R O K E C A R E IN HO NG KO NG xix
AC KN OW L ED G EMEN TS xxiii
1 Setting the Scene 1
Caroline Watkins and Dominique Cadilhac
1.1 Introduction 1
1.2 Stroke Epidemiology 2
1.3 Cost Burden 3
1.4 Stroke Policy 4
1.5 Stroke Management Strategies 8
1.6 Research and Education 11
1.7 Conclusion 13
References 13
2 What Is a Stroke? 19
Anne W. Alexandrov
2.1 Introduction 19
2.2 Stroke Classification 20
2.3 Risk Factors for Stroke 22
2.4 Anatomy, Physiology, and Related Stroke Clinical Findings 23
2.5 Standardised Instruments for Acute Neurological Assessment 41
2.6 Conclusion 44
References 50
3 Reducing the Risk of Stroke 53
Josephine Gibson and Stephanie Jones
3.1 Introduction 54
3.2 Primary Prevention 55
3.3 Primary Prevention – Medical Considerations 56
3.4 Secondary Medical Prevention After TIA or Stroke 59
3.5 Interventions for Secondary Prevention After TIA or Recovered
Stroke 63
3.6 Conclusion 68
References 68
v
Second Edition
,Stroke Nursing
Second Edition
Edited by
JANE WILLIAMS
Southern Health Foundation Trust
Southampton, UK
LIN PERRY
University of Technology Sydney
Northern Hospitals Network
South Eastern
Sydney Local Health District
Sydney, NSW, Australia
CAROLINE WATKINS
University of Central Lancashire
Preston, UK
,This edition first published 2020
© 2020 by John Wiley & Sons Ltd
Edition History [1e, 2010]
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or
transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or other-
wise, except as permitted by law. Advice on how to obtain permission to reuse material from this title
is available at http://www.wiley.com/go/permissions.
The right of Jane Williams, Lin Perry, and Caroline Watkins to be identified as the author of editorial
in this work has been asserted in accordance with law.
Registered Office(s)
John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, USA
John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK
Editorial Office
9600 Garsington Road, Oxford, OX4 2DQ, UK
For details of our global editorial offices, customer services, and more information about Wiley prod-
ucts visit us at www.wiley.com.
Wiley also publishes its books in a variety of electronic formats and by print‐on‐demand. Some content
that appears in standard print versions of this book may not be available in other formats.
Limit of Liability/Disclaimer of Warranty: The contents of this work are intended to further general
scientific research, understanding, and discussion only and are not intended and should not be relied
upon as recommending or promoting scientific method, diagnosis, or treatment by physicians for any
particular patient. In view of ongoing research, equipment modifications, changes in governmental
regulations, and the constant flow of information relating to the use of medicines, equipment, and
devices, the reader is urged to review and evaluate the information provided in the package insert
or instructions for each medicine, equipment, or device for, among other things, any changes in the
instructions or indication of usage and for added warnings and precautions. While the publisher and
authors have used their best efforts in preparing this work, they make no representations or warran-
ties with respect to the accuracy or completeness of the contents of this work and specifically disclaim
all warranties, including without limitation any implied warranties of merchantability or fitness for
a particular purpose. No warranty may be created or extended by sales representatives, written sales
materials or promotional statements for this work. The fact that an organization, website, or product
is referred to in this work as a citation and/or potential source of further information does not mean
that the publisher and authors endorse the information or services the organization, website, or prod-
uct may provide or recommendations it may make. This work is sold with the understanding that the
publisher is not engaged in rendering professional services. The advice and strategies contained herein
may not be suitable for your situation. You should consult with a specialist where appropriate. Further,
readers should be aware that websites listed in this work may have changed or disappeared between
when this work was written and when it is read. Neither the publisher nor authors shall be liable for
any loss of profit or any other commercial damages, including but not limited to special, incidental,
consequential, or other damages.
Library of Congress Cataloging‐in‐Publication Data
Names: Williams, Jane (Jane E.), editor. | Perry, Lin, editor. | Watkins, Caroline, editor.
Title: Stroke nursing / edited by Jane Williams, Lin Perry, Caroline Watkins.
Other titles: Acute stroke nursing
Description: Second edition. | Hoboken, NJ : Wiley-Blackwell, 2019. | Preceded by: Acute stroke
nursing / edited by Jane Williams, Lin Perry, Caroline Watkins. 2010. | Includes bibliographical
references and index. | Identifiers: LCCN 2018054706 (print) | LCCN 2018057605 (ebook) |
ISBN 9781119111467 (AdobePDF) | ISBN 9781119111474 (ePub) | ISBN 9781119111450 (pbk.)
Subjects: | MESH: Stroke–nursing | Evidence-Based Nursing
Classification: LCC RC388.5 (ebook) | LCC RC388.5 (print) | NLM WY 152.5 | DDC 616.8/10231–dc23
LC record available at https://lccn.loc.gov/2018054706
Cover Design: Wiley
Cover Image: © KTSDESIGN/SCIENCE PHOTO LIBRARY/Getty Images
Set in 10/12pt Stix by SPi Global, Pondicherry, India
10 9 8 7 6 5 4 3 2 1
, Contents
E D I TO RS A N D CO N T R IB UTO RS ix
FOREWO R D : ST R O K E N URS IN G xiii
FOREWO R D : ST R O K E S ERVIC ES IN AUST RA L IA xv
FOREWO R D : ST R O K E C A R E IN HO NG KO NG xix
AC KN OW L ED G EMEN TS xxiii
1 Setting the Scene 1
Caroline Watkins and Dominique Cadilhac
1.1 Introduction 1
1.2 Stroke Epidemiology 2
1.3 Cost Burden 3
1.4 Stroke Policy 4
1.5 Stroke Management Strategies 8
1.6 Research and Education 11
1.7 Conclusion 13
References 13
2 What Is a Stroke? 19
Anne W. Alexandrov
2.1 Introduction 19
2.2 Stroke Classification 20
2.3 Risk Factors for Stroke 22
2.4 Anatomy, Physiology, and Related Stroke Clinical Findings 23
2.5 Standardised Instruments for Acute Neurological Assessment 41
2.6 Conclusion 44
References 50
3 Reducing the Risk of Stroke 53
Josephine Gibson and Stephanie Jones
3.1 Introduction 54
3.2 Primary Prevention 55
3.3 Primary Prevention – Medical Considerations 56
3.4 Secondary Medical Prevention After TIA or Stroke 59
3.5 Interventions for Secondary Prevention After TIA or Recovered
Stroke 63
3.6 Conclusion 68
References 68
v
