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Module 4 > Cerebrovascular Accident > Flashcards

Cerebrovascular Accident Flashcards

1
Q

Stroke

A

Ischemia or hemorrhage

TIA
Medical emergency
Result in death of brain cells
Primary cause of adult disability in the US

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2
Q

Ischemia

A

Inadequate blood flow to a part of the brain

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3
Q

Hemorrhage

A

Bleeding into the brain

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4
Q

Teaching about stroke

A

Prevention!! Andteaching

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5
Q

Non modifiable risk factors

A

Age
Gender
Ethnicity
Hereditary / family history

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6
Q

Modifiable risk factors

A

Uncontrolled hypertension
Heart disease
Diabetes
Serum cholesterol
Smoking
Obesity
Sleep apnea
Metabolic syndrome
Lack of physical excercise
Poor diet
Drug and alcohol abuse

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7
Q

Oral contraceptives

A

Cause blood clots , dvt

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8
Q

Types of strokes

A

Transient ischemic attack (TIA)
Ischemic
Hemorrhagic

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9
Q

Pt that have a fib

A

25% of strokes give blood thinners for a fib

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10
Q

TIA

A

Acute infarction of brain symptoms
Warning sign of further cerebrovascular accident
Last for lessthan an hour
Treated as a real stroke
Medical emergency

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11
Q

Ischemic stroke

A

Results from inadequate blood flow to brain from partial or incomplete occlusion of an artery
Thrombotic
Embolic

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12
Q

Thrombotic stroke

A

Injury to a blood vessel wall and formation of a blood clot
Results from thrombosis or narrowing of a blood vessel
Can be preceded by TIA
Associated with DM and HTN
Most common cause of stroke

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13
Q

Embolic stroke

A

Embolus dislodges and occludes a cerebral artery resulting in infarction and edema , comes from other part of body but usually from endo cardiac layer of heart , bowel replacement

Effects pt with MI , a fib ,

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14
Q

S/s of Embolic stroke

A

Pt remains conscious
Prognosis is related to amount of brain tissue deprived of blood supply
Complains of headaches
Symptoms can be temporary if clot is broken up
Can reoccur unless underlying cause is treated

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15
Q

Hemorrhagic stroke

A

Caused by bleeding into the brain tissue, ventricles or sub arachnoid space
Causes can vary - HTN ,aneurysm , intracranial neoplasm ,AVM
Deficit are severe and recovery is long
Can happen during periods of activity

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16
Q

Sub arachnoid Hemorrhagic stroke s/s

A

N&v
Headache
Seizure
Stiff neck

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17
Q

Intracerebral hemorrhage

A

Bleeding within the brain caused by ruptured vessel
Sudden onset of symptoms
Progresses from minutes to hours because of ongoing bleeding
Prognosis poor
Hypertension
Occurs during activity
Deaths within i the first 48 hours

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18
Q

Subarachnoid hemorrhage

A

Intracranial bleeding into cerebrospinal fluid filled space between arachnoid and pia mater
Commonly caused by rupture of a cerebral aneurysm
Silent killer
MORE common in women

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19
Q

Intracerebral hemorrhage s/s

A

Headaches
N&v
decrease LOC
Neuro defecits
Happens during activity

20
Q

Hemorrhagic stroke complications

A

Neuro and systematic complications
Cerebral vasospasm

Hyponatremia
Myocardial ischemia and infarction ARDS

21
Q

What do you give when a pt has a cerebral vasospasm following an aneurysm

A

Administration of calcium channel blocker Nimodipine

22
Q

manifestiations of stroke
Cognitive

A

Memory loss, decrease attention span
Poor reasoning
Altered judgement

23
Q

Psychological effects of stroke

A

Loss of self control
Depression
Emotions lability(can’t control feelings)
And elimination

24
Q

Hemiplegia hemiparesis

A

Paralysis and weakness on one side of body

25
Q

Ataxia

A

Lack of motor control

26
Q

dysarthria

A

Disturbance in muscle control of speech

27
Q

Dysphasia

A

Impaired ability to communicate

28
Q

Expressive Aphasia

A

Unable to express what they want to say

29
Q

Receptive aphasia

A

Unable to receive or understand

30
Q

Dysphagia

A

Inability to swallow at risk for aspiration

31
Q

Spatial perceptual alterations

A

Homonymous hemianopsia
Loss of peripheral vision
Agnostic
Apraxia

32
Q

Homonymous hemianopsia

A

Blind on one side of the body

33
Q

Agnosia

A

The ability to recognize an object by touch and site

34
Q

Apraxia

A

The inability to carry out commands

35
Q

Diagnostic studies for stroke

A

CT scan or MRI
ECG , labs

36
Q

What do CT scan or MRI identify

A

Size and location of lesion
Differentiate between ischemic
And hemorrhagic stoke

37
Q

If a CT scan shows a bleed what’s next

A

MRI so they can see a much bigger picture

38
Q

Ischemic stroke medical management

A

Thrombolytic therapy within 3 hours of s/s TPA

39
Q

TPA

A

Need noncontrast CT of head
Blood tests for coagulation studies
Screening for history of GI bleeding in past 3 months or major surgery in last 14 days (recent stroke , head trauma within 3 months )

40
Q

TPA cont

A

Will be in icu for first 24 hours to montor BP
Risk for bleeding first 48 hrs
Start foley to prevent falls and bleeding

41
Q

Surgical management for stroke

A

Carotid endarterectomy
Carotid stenting
Aneurysm clipping, coiling
Resection of arteriosclerosis malformation (AVM)

42
Q

Coiling , clipping

A

For hemorrhagic

43
Q

Carotid endarterectomy

A

For ischemia stroke

Lesion is removed from carotid artery to improve blood flow

44
Q

Stenting

A

Ischemic -thrombo

45
Q

Nimodipine

A

Calcium channel blocker
Give for cerebral vasospasm to prevent myocardial ischemia and infarction , ARDS ( complication frin hemorrhagic stroke)

46
Q

Prentice drug therapy for stroke

A

Warfarin a-fib
Anti platelets; Clopidogrel , aspirin
Statins
Antihypertensive

47
Q

Bladder retraining

A

Encourage pt to go once every two hours
Avoid use of indwelling Catheters

Offer urinal or bed pan on schedule

Module 4 (47 decks)

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