Acute Ischemic Stroke

Question 1

It is a sudden onset of acute neurologic deficit persisting for more than 24 hours that is caused by an interruption of blood flow of the brain.

Answer 1

Acute Ischemic Stroke

Question 2

What occurs in the effect of infarcted tissue that may further contribute to neuronal cell death?

Answer 2

Edema

Question 3

What is the so-called “salvage brain area” wherein the tissue surrounding the ischemic area receives the dome perfusion?

Answer 3

Penumbra

Question 4

In ischemic stroke, what often develops during periods of sleep or inactivity when blood flow is less risky?

Answer 4

Thrombotic strokes

Question 5

What test usually the main goal is to maintain the normal maintain status and level of alertness unless the AS is affected?

Answer 5

Romberg’s test

Question 6

It correlates cerebrovascular and cardiovascular disease

Answer 6

Cardiac Biomarkers

Question 7

What are the biomarkers of myocardial infarction?

Answer 7

1. Ischemia-modified albumin (IMA)

2. Heart-type fatty acid-binding protein (H-FABP)

Question 8

What is the goal of initial diagnosis?

Answer 8

To differentiate hemorrhagic vs ischemic

Question 9

What is the indication of cerebral angiography and carotid ultrasound

Answer 9

To detect vascular abnormalities

Question 10

What are the biomarkers of myocardial necrosis?

Answer 10

CK- MB fraction, myoglobin, cardiac troponins

Question 11

What are the three important principles of management in acute ischemic stroke?

Answer 11

1. Restore circulation to the brain
2. Stop ongoing ischemic process
3. Prevent secondary complications

Question 12

What is the recommended dose for rtPA?

Answer 12

0.9mg/kg with 10% total dose given as bolus over 1-2mins

Question 13

What are the top 3 nursing diagnoses when managing stroke?

Answer 13

1. Ineffective Gas Exchange or Ineffective Breathing Pattern
2. Risk for Cardiac Output
3. Imbalanced Nutrition

Question 14

What is the target glucose level for glucose management?

Answer 14

140- 180 mg/dL

Question 15

When is blood pressure treated emergently?

Answer 15

When SBP >22 mmHg or DBP >110 mmHg

Question 16

What endovascular treatment is considered to be used for patients with middle cerebral artery occlusion that can be treated within 6 hours?

Answer 16

rt-PA (for intra-arterial use)

Question 17

For blood pressure management, what medications should be withheld to maximize cerebral blood flow?

Answer 17

Antihypertensive medications

Question 18

Used for emergency treatment for ischemic stroke to prevent recurrent attack. This prevents blood clot to form in leg vein or different veins of the body

Answer 18

Anti-coagulant (Heparin)

Question 19

Prevent arteries from being clogged; use to manage acute ischemic stroke and prevention of stroke, particularly to those patients whose at high risk for atherosclerosis

Answer 19

Antiplatelet medication (Aspirin)

Question 20

What medication treatment do we usually give to patients with DBP >140 mmHg during and after teh treatment?

Answer 20

Sodium nitroprusside [0.5 mcg/kg.min]