Acute Ischemic Stroke Flashcards
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.
Acute Ischemic Stroke
What occurs in the effect of infarcted tissue that may further contribute to neuronal cell death?
Edema
What is the so-called “salvage brain area” wherein the tissue surrounding the ischemic area receives the dome perfusion?
Penumbra
In ischemic stroke, what often develops during periods of sleep or inactivity when blood flow is less risky?
Thrombotic strokes
What test usually the main goal is to maintain the normal maintain status and level of alertness unless the AS is affected?
Romberg’s test
It correlates cerebrovascular and cardiovascular disease
Cardiac Biomarkers
What are the biomarkers of myocardial infarction?
- Ischemia-modified albumin (IMA)
2. Heart-type fatty acid-binding protein (H-FABP)
What is the goal of initial diagnosis?
To differentiate hemorrhagic vs ischemic
What is the indication of cerebral angiography and carotid ultrasound
To detect vascular abnormalities
What are the biomarkers of myocardial necrosis?
CK- MB fraction, myoglobin, cardiac troponins
What are the three important principles of management in acute ischemic stroke?
- Restore circulation to the brain
- Stop ongoing ischemic process
- Prevent secondary complications
What is the recommended dose for rtPA?
0.9mg/kg with 10% total dose given as bolus over 1-2mins
What are the top 3 nursing diagnoses when managing stroke?
- Ineffective Gas Exchange or Ineffective Breathing Pattern
- Risk for Cardiac Output
- Imbalanced Nutrition
What is the target glucose level for glucose management?
140- 180 mg/dL
When is blood pressure treated emergently?
When SBP >22 mmHg or DBP >110 mmHg
What endovascular treatment is considered to be used for patients with middle cerebral artery occlusion that can be treated within 6 hours?
rt-PA (for intra-arterial use)
For blood pressure management, what medications should be withheld to maximize cerebral blood flow?
Antihypertensive medications
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
Anti-coagulant (Heparin)
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
Antiplatelet medication (Aspirin)
What medication treatment do we usually give to patients with DBP >140 mmHg during and after teh treatment?
Sodium nitroprusside [0.5 mcg/kg.min]
