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EXAM 1: PNR MED > CH 49 > Flashcards

CH 49 Flashcards

1
Q

What is a TRANSIENT ISCHEMIC ATTACK?

A

blockage of blood to the brain
-depriving oxygen and glucose
Lasts minutes to hours- recover completely
1/3 of pt with TIA will have a STROKE in 5 future

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2
Q

What is a penumbra?

A

area of brain tissue surrounding the damage

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3
Q

What are 2 types on ischemic stokes?

A

Thrombotic

Embolic

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4
Q

An ischemic stroke occurs when…

A

blood supply to brain is blocked or slowed

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5
Q

Thrombotic stroke occurs when…

A

occlusion builds up in artery

*internal or common carotid artery

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6
Q

Embolic stroke occurs when…

A

blood clot created (typically in heart), travels through arteries and traps in small vessel.

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7
Q

Hemorrhagic stoke are caused by..

A

rupture of cerebral blood vessel, allowing blood to escape in brain tissue.

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8
Q

What are the 2 types of HEMORRHAGIC STROKE?

A

Subarachnoid Hemorrhage

Intercerebral Hemorrhage

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9
Q

What is subarachnoid hemorrhage?

A

ruptured cerebral aneurysm, occurs on surface of brain

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10
Q

What is a intracerebral hemorrhage?

A

caused by uncontrolled hypertension, deeper tissues of brain

*may experience undetected many times.

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11
Q

Modifiable Risk Factors for Stroke

A 
HTN
Smoking
Diabetes
CV disease, Atrial fib
Asymotomatic carotid stenosis
TIA
Sickle cell anemia
Dyslipidemia
Obesity
Alcohol
Poor diet, No exercise
Postmenopausal hormone therapy
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12
Q

Nonmodifiable Risk factors Stroke

A

older age
gender (MALE)
Heredity
prior stoke or heart attack

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13
Q

Warning signs of a stroke

A

Numbness or weakness in face, arm, leg (one side of body)
Confusion, trouble speaking
trouble seeing in one or both eyes
Trouble walking, dizziness, loss of balance
Severe HA, no cause

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14
Q

Remember FAST

A

FACE droop
ARMS drift
SPEECH
TIME

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15
Q

Acute S&S of stroke include:

A 
one side weakness/paralysis
Dysphagia
Sensory loss
Mental status change
Visual disturbances
Speech Disturbances
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16
Q

What is global aphasia?

A

both receptive and expressive aphasia are present

17
Q

What is dysarthria?

A

slurred or indistinct speech (lack of coordination)

18
Q

What is ataxia?

A

poor balance and stumbling, staggering gait

19
Q

Homonymous hemianopisia is..

A

visual deficit on same side half of each visual field

20
Q

CT scan is vital in diagnosing and treating a….

A

hemorrhagic stroke

21
Q

Other tests to be completed upon arrival in ER…

A 
EKG
CBC, Electrolytes, glucose
Metabolic panel
PT, INR
NIH Stroke Scale
Carotid Doppler
Cerebral Angiogram
22
Q

What will the nurse monitor, while results are pending? (hemorrhagic or ischemic)

A

A’ airway
-O2 if sat >92%, and LOC decreased
B’ breathing
C’ circulation

 - Vitals and heart rhythm are monitored
 - temp >99.6 treated
 - IV fluids - NO glucose
 - tPA                  -BP control
23
Q

A thrombolytic can be administered within…

A

3 hours of onset for ischemic attacks

24
Q

Patients suffering from a stoke are at risk for

A

ICP——> brain damage

Further stokes

25
Q

If receiving tPA, BP must be maintained..

A

below 185/110

26
Q

What antihypertensive meds will a stoke pt receive?

A 
beta blockers (labetalol)
calcium channel blocker (nicardipine)
27
Q

Prevention of DVT includes:

A

SCD’s/ elastic stockings
heparin
warfarin
lovenox

28
Q

Meds for CV Disorders

A

Thrombolytic
Antiplatlet
Anticoagulants
Statins

29
Q

What is an endartectomy?

A

surgical removal of occlusion from artery

If not a good candidate, carotid angiogram with stent may be used

30
Q

Right side Infract

A

Left sided weakness/ paralysis
Impaired judgement/ safety risk
Unilateral neglect
indifferent to disability

31
Q

Left side Infract

A

Right sided weakness
Aphasia
Depression r/t disability

32
Q

Stoke Prevention includes:

A

Controlling weight, HTN, Cholesterol
NO smoking
Aspirin, Warfarin

33
Q

Signs and symptoms of small hemorrhage:

A

mild headache, vomiting, disorientation
“flu like symptoms”
**may not seek tx

34
Q

A rupture of an aneurysm will present as a..

A 
severe headache
changes in LOC 
ICP
Generalized seizures
Nuchal Rigidity
35
Q

Diagnosis of an aneurysm requires

A

cerebral angiogram

CT scan

EXAM 1: PNR MED (6 decks)

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