Cerebral Vascular Accident

Question 1

What kinds of medications are used to prevent a TIA/stroke?

Answer 1

antiplatelets

Question 2

Plavix (clopidogrel) & Ticlid (ticlopidine) are what kinds of meds?

Answer 2

antiplatelets

Question 3

Xarelto (rivaroxaban) is what kind of med?

Answer 3

anticoagulant

Question 4

Ischemic stroke are due to?

Answer 4

Thrombus or Embolism (blockage)

Question 5

Hemorrhagic strokes are do to?

Answer 5

a ruptured aneurysem

Question 6

Large artery thrombotic strokes consist of?

Answer 6

atherosclerotic plagues and thrombosis formation at the site

Question 7

Small penetrating thrombotic strokes consist of?

Answer 7

poorly controlled HTN, DM and /or hyperlipidema

Question 8

A cardiogenic embolic stroke is due to?

Answer 8

Afib

Question 9

Difference between a cerebral thrombosis and a cerebral embolism

Answer 9

Cerebral thrombosis occurs rapidly & progresses slowly, can start off as a TIA and progress to a stroke. A cerebral embolism is a clot/plaque that travels to the brain. It is sudden & has immediate deficits. Treat with thrombolytic agents

Question 10

Who cant have thrombolytic therapy?

Answer 10

Intracranial/ spinal surgery, head trauma, or stroke, within the past 3 months, suspicion of hemorrhage, hx of intracranial hemmorrage, uncontrolled HTN, Internal bleeding, seizure at the onset of stroke, intracranial neoplasm, AV malformaton, or has an aneurysm, current use of oral anticoagulants, INR greater than 1.7, PT greater than 15 secs

Question 11

Reperfusion by Embolectomy

Answer 11

basically pulls clot out (looks like a wine screw)

Question 12

Why is a cerebral hemorrhage common in older people?

Answer 12

because their arteries are not has stiff, they have an increase of peripheral resistance and a decrease in CO

Question 13

Why is cerebral hemmorrhage common in people with HTN?

Answer 13

because they have a decrease in diastolic BP & an increase in systollic BP

Question 14

Difference between intracerebral hemorrhage & subarachnoid hemorrhage

Answer 14

Intracerebral hemorrhage blood goes into tissues (stop any anticoaglants and put on steriods), Subarachnoid hemorrhage blood goes ontop of brain so we can go in surgically and remove blood

Question 15

What do you do when a person has a stroke and you arrive at their home?

Answer 15

check bp/glucose, give O2, FAST (face, arm, speech, time) and then give IV access in transit

Question 16

Care in the acute phase of a Stroke, the first 24-48 hours

Answer 16

O2, elevate HOB, no flexing or twisting the neck, monitor vs changes to indicate ICP, Seizure precautions, I&O

Question 17

If the stroke is due to a thrombolitic, what will you do?

Answer 17

youll give a clot bustor or do reperfusion by emolectomy

Question 18

If stroke is due to a hemorrhage what will you do?

Answer 18

use supportive care

Question 19

What is Decadron?

Answer 19

its a steroid and it helps with swelling in the brain and prevents further damage

Question 20

s/s of ischemic stroke

Answer 20

numbness/weakness of face, arms or legs, slurred speech and difficulty with comprehension

Question 21

s/s of a hemorrhagic stroke

Answer 21

“Exploding” h/a, Altered LOC, NV, seizures, Visual changes

Question 22

what is contralateral deficit?

Answer 22

if your body is effected on the left side, the right side of your brain is effected

Question 23

s/s of Left side problem

Answer 23

Aphasia (inability/impairment to communicate), expressiev or receptive or global (both expressive & receptive) problems, Dysartia (prob pronouncing words), memory deficits,, difficulty learning something new, difficulty distinguishing from right to left

Question 24

s/s of right side problem

Answer 24

misjudge distances, apraxia (inability to use objects properly), inappropriate social behavior, short attention span, left sided neglect, cant recognize own arms/legs

Question 25

s/s of stroke effecting the brain stem

Answer 25

decrease in breathing/HR & a decrease in arousal/consciousness

Question 26

s/s of stroke effecting the cerebellum

Answer 26

balance problems (ataxia), abnormal reflexes of the head & upper body, dizziness, n/v

Question 27

what do you do for a patient with ICP?

Answer 27

maintain airway, monitor VS, elevate HOB 30 degrees, avoid neck flection, give O2, decrease stimuli, decrease cerebral edema with diuretics, give decadron, restrict fluids to 1500 ml/day, glascow scale

Question 28

Hemiparesis vs hemiplegia

Answer 28

Ability to move at least one side of body; cant move at all

Question 29

Fluoxetine (Prozac), Methylphenidate ( Ritalin) & Nortriptyline (Aventyl) are used for what?

Answer 29

to treat depression that comes along with a stroke

Question 30

How should you have the HOB during the acute phase of a stroke?

Answer 30

elevated

Question 31

How should you have the HOB for ICP?

Answer 31

30 degrees

Question 32

Rehab phase

Answer 32

teach patient about meds to be taken after discharge, reinforce gait training and transfer techniques, teach that they need follow up care