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409 3 Flashcards

1
Q

Offers the worst prognosis if occluded

A

Basilar Artery

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2
Q

Patients with ___ and ____ frequently present with small ischemic stroke syndromes (Lacunar stroke)

A

diabetes and hypertension

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3
Q

Patients with Middle Cerebral Artery stroke are at risk for

A

seizures and herniation

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4
Q

50% of trombotic stroke patient have

A

TIAs

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5
Q

When does thrombotic stroke normally happen

A

night

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6
Q

Most catastrophic type of stroke

A

HEMORRHAGIC

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7
Q

Hemorrhage Symptoms: ____ intolerance

A

light

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8
Q

Hemorrhage Symptoms: ___ pain

A

neck

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9
Q

the single most important determinant of treatment options during the hyperacute phase.

A

when the stroke started

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10
Q

IS RARELY NECESSARY WITHIN THE FIRST MINUTES FOLLOWING A STROKE

A

INTUBATION

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11
Q

Impulsive or unorganized in Activities of Daily Living

A

LEFT HEMIPLEGIA (RIGHT SIDED HEMISPHERE)

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12
Q

Lack insight into these problems

A

LEFT HEMIPLEGIA (RIGHT HEMISPHERE)

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13
Q

Limits or eliminate words

A

RIGHT HEMIPLEGIA (LEFT HEMISPHERE)

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14
Q

Vocabulary and auditory span reduced

A

RIGHT HEMIPLEGIA (LEFT HEMISPHERE)

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15
Q

Left or Right problem? Left gaze preference

A

Left

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16
Q

Left or Right problem? Right visual field deficit

A

Left

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17
Q

Left or Right problem? Right hemiparesis

A

Left

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18
Q

Left or Right problem? Right hemisensory loss

A

Left

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19
Q

Left or Right problem? Right gaze preference

A

Right

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20
Q

Left or Right problem? Left visual field deficit

A

Right

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21
Q

Left or Right problem? Left hemiparesis

A

Right

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22
Q

Left or Right problem? Left hemisensory loss neglect (left hemi-inattention)

A

Right

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23
Q

Stroke: VOMITING SHOULD BE TREATED WITH

A

ANTIEMETICS AND NGT

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24
Q

WHEN STROKE OCCURS, AN ELEVATED BLOOD PRESSURE is always REDUCED IF THE STROKE IS

A

HEMORRHAGIC

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25
Q

IF ISCHEMIC, ELEVATIONS IN BLOOD PRESSURE SHOULD NOT BE IMMEDIATELY TREATED UNLESS: SYSTOLIC BLOOD PRESSURE EXCEEDS

A

220

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26
Q

IF ISCHEMIC, ELEVATIONS IN BLOOD PRESSURE SHOULD NOT BE IMMEDIATELY TREATED UNLESS: you have identified ____ ischemia, __, or ____ ____

A

CARDIAC ISCHEMIA, HF, AORTIC DISSECTION

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27
Q

IF ISCHEMIC, ELEVATIONS IN BLOOD PRESSURE SHOULD NOT BE IMMEDIATELY TREATED UNLESS: DIASTOLIC BLOOD PRESSURE EXCEEDS

A

110 ON REPEATED MEASUREMENTS MADE OVER 30 TO 60 MINUTES

28
Q

IF ISCHEMIC, ELEVATIONS IN BLOOD PRESSURE SHOULD NOT BE IMMEDIATELY TREATED UNLESS: _____ THERAPY WILL BE USED

A

THROMBOLYTIC

29
Q

In the 1st few hours after the stroke, BP

A

declines on its own

30
Q

Stoke: CT SCAN IS CRUCIAL AS IT ALLOWS FOR ACCURATE EXCLUSION OF

A

HEMORRHAGIC STROKE

31
Q

Thrombolytic Tx: Rt-PA is packaged as a crystalline powder and is reconstituted with

A

sterile water

32
Q

Thrombolytic Tx: Rt-PA: Dosing:

A

Give a 10% bolus over 1 minute

Give the rest (90%) over 1 hour

33
Q

Thrombolytic Tx: Rt-PA: Dosing: Max dose for any patient is

A

90mg

34
Q

Thrombolytic Tx: Rt-PA: To prevent accidental overdose, it is important to

A

waste amount with another nurse before administering to patient.

35
Q

Thrombolytic Tx: Rt-PA: Prior to administering rt-PA make sure all

A

invasive lines are in place (e.g., endotracheal and indwelling urinary catheter)

36
Q

Criterion for thrombolytic tx: ct scan to rule out

A

hemorrhage

37
Q

Thrombolytic Tx: must start within

A

3 hours

38
Q

Do you give thrombolytic tx if neuro deficit starts to improve

A

no

39
Q

Thrombolytic Tx contraindicated if patient is taking anti____

A

anticoagulants

40
Q

Thrombolytic Tx contraindicated if PT is

A

greater than 15 seconds

41
Q

Thrombolytic Tx contraindicated if platelet count is

A

less than 100,000

42
Q

Thrombolytic Tx contraindicated if BP

A

is over 180/110

43
Q

Thrombolytic Tx contraindicated if there’s a h/o

A

stroke or head trauma in the past 3 months

44
Q

Thrombolytic Tx contraindicated if patient had major

A

surgery in the past 2 weeks

45
Q

Thrombolytic Tx contraindicated if patient had GI or GU

A

bleed in the past 2 weeks

46
Q

Thrombolytic Tx contraindicated if at the onset of the stroke

A

patient had a seizure

47
Q

Stroke tx: No oral feeding for

A

24 hours

48
Q

Stroke: fatal secondary complication

A

P.E.

49
Q

Stroke: complication that happens 10% of the time

A

pneumonia

50
Q

Stroke recovery: what do you do with the limbs

A

support with pillows

51
Q

Patients treated with Thrombolytics: Call physician if systolic is

A

greater than 180 or less than 110

52
Q

Patients treated with Thrombolytics: Call physician if Diastolic is

A

greater than 100 or less than 60

53
Q

Patients not treated with thrombolytics: Call physician if Diastolic is

A

greater than 120 or less than 60

54
Q

Patients not treated with thrombolytics: Call physician if systolic is

A

greater than 220 or less than 110

55
Q

Patients treated with thrombolytics: what should you know about antithrombotics

A

No heparin etc for 24 hours

56
Q

Patients NOT treated with thrombolytics: what should you know about antithrombotics

A

they are indicated within the 1st 24 hours

57
Q

Stroke tx: use NC to maintain saturation at

A

greater than 92%

58
Q

You can’t have thrombolytics if systolic is

A

greater than 220

59
Q

You can’t have thrombolytics if Diastolic is

A

greater than 120

60
Q

3 good meds for a stroke patient with high BP is

A

lol, nicardinpine, nitropruss

61
Q

Stroke: Cerebral autoregulation is lost, therefore the patient is at risk for

A

hypertension

62
Q

Stroke: Most common cause of deterioration and early death

A

Cerebral Edema

63
Q

2 Late signs of ICP

A

pupillary change

wider pulse pressure

64
Q

Transient Cerebral Ischemia definition

A

brain ischemia caused by stenosis; it goes away in 24 hours

65
Q

Ask visitors to stand on the stroke patient’s ___ side

A

affected

aa Orgo (196 decks)

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