Ischemic stroke occurs when blood does not circulate to a particular part of the brain inhibiting neurologic functions. Blood circulation in the brain is prevented by the blocking of arteries thus limiting the supply of oxygen and nutrients to neurons which generate energy. The stroke requires immediate medical attention to unblock the artery and allow oxygen into the brain. Dual antiplatelet therapy is a medical practice that is used in blocking platelets which facilitate blood clotting. Prevention of blood clotting minimizes blocking of the arteries thus reducing cases of ischemic stroke (Geeganage et al., 2012). Dual antiplatelet therapy reduces the risk of an ischemic stroke from recurring in the long-term.
Although the DAPT is beneficial in reducing risks of ischemic stroke it increases cases of major bleeding among patients. The therapy has been noted to increase cause mortality. The risk of subsequent strokes among ischemic stroke survivors can also be reduced through the use of aspirin. Aspirin helps in thinning the blood hence preventing it from clotting (White et al., 2013). Doctors advise that patients should be given aspirin immediately they suffer from the stroke to prevent another stroke from happening. Aspirin is effective in preventing strokes that recur within the first year hence cannot be used for long-term purposes. Aspirin is also cost effective making it a common preventive measure.
Adding Clopidogrel To Aspirin
Lacunar stroke is a form of ischemic stroke which is experienced when small arteries that are located deep within the brain are blocked. The blockage of the arteries prevents the flow of blood to vital parts of the brain and most cause high blood pressure which makes the arteries narrow. Lacunar stroke is diagnosed with aspirin to prevent another attack from happening. Adding clopidogrel to aspirin reduces the chances of stroke attacking patients with acute coronary syndromes and atrial fibrillation (White et al., 2013). The combination increases the risk of hemorrhage leading to more deaths. Benavente explains that the combination helps in preventing the risk of a secondary ischemic stroke among survivors and is supposed to be initiated early for it to be effective. Secondary lacunar stroke can also be prevented through magnetic resonance imaging (sPs3 Investigators, 2012).
Mechanically ventilated adult
Recently, the most medical population of the ICU patients have been faced challenges of prolonged bed rest for critical illness in need of mechanical ventilation. During critical illness patients that are immobilized have had neuromuscular weakness despite them having full bed rest supportive care. Bedrest among patients increases their stay in the hospital and leads to weakening and wasting of their muscles hence they are not able to perform activities on their own. This has led to increased length and duration of stay and poor life quality among the survivors. However, safety, benefits, and feasibility of early mobilization have led to improved results for the mechanically ventilated patients in the ICU. There has been growing indication for supporting mobilization for the critically ill adult patients in the intensive care unit (Nydahl et al.,2014). Mobilization is the administering of physical therapy that is applied to critically ill patients within the first 2-5 days of their illness. Mobilization has led to benefits such as a reduced period of stay in the hospital and in the ICU. It has also led to improvements in functional status and strength of the patients. This is whereby the patient’s muscles are made strong thus preventing muscle atrophy. Mobility has also brought the interaction between body and mind which has been important in improving the awareness of the patient hence leading to reduction being noted in the ICU delirium (Schaller 2016). Mobilization improves how patients function when they are discharged from the hospital due to strong muscles (Schaller et al., 2016). Strong muscles enable them to become independent enabling them to perform various activities on their own. Early mobilization of patients, therefore, is safe and leads to reduced ventilator time, enhanced functional mobility and reduced time of stay. It is therefore important that mobilization ventilated patients should progress for active interventions that will provide patient benefit. Mobilization has appeared psychologically logical to the patients who would have otherwise been immobilized hence being more feasible and safe process. Its main intention, therefore, is the restoration of musculoskeletal strength, patient-centered outcomes and improving functionality.