ch 57 stroke Flashcards
two types stroke
ischemic
hemorrhagic
stroke caused by clot within artery of brain
ischemic
type of ischemic stroke due to atherosclerosis
thrombotic
type of ischemic stroke due to clot from other part of body that travels to brain (ex: DVT)
embolic
risk factor for embolic stroke
Afib
S+S stroke that disappear within three hours
transient ischemic attack
treatment for transient ischemic attack
preventative aspirin
risk factor/cause hemorrhagic stroke
uncontrolled HTN
general risk factors for stroke (10)
- older age (>50)
- family h/o
- HTN
- metabolic syndrome
- high cholesterol
- diabetes
- alcohol abuse
- sleep apnea
- obesity
- smoking
S+S stroke to teach pts
FACE: Face uneven Arm one drooped Speech slurred Time call 911
S+S stroke that affected frontal lobe (3)
- intellect
- cognition
- critical thinking
S+S stroke that affected parietal lobe (1)
-motor movement
S+S stroke that affected temporal lobe (2)
- impaired expression and understanding of speech
- reading
S+S stroke that affected occipital lobe (2)
- visual impairment
- balance
S+S stroke that affected R side of brain (L side of body) (4)
- spatial perceptual problems
- short attention span
- impaired judgment
- impulsive behavior*
S+S stroke that affected L side of brain (R side of body) (4)
- impaired speech
- slowness
- awareness of deficits
- impaired cognitive function (reading, writing, math)
3 types ischemic stroke
- embolic
- transient ischemic attack
- thrombotic
what type of ischemic stroke is associated with headache
embolic
S+S hemorrhagic stroke (5)
- neurologic deficits
- headache
- N/V
- decreased LOC
- HTN
2 types aphasia
broca’s aphasia
wernicke’s aphasia
type of aphasia characterized by nonfluent, short phrases
broca’s aphasia
type of aphasia characterized by fluent speech that doesn’t make sense, impaired comprehension
wernicke’s aphasia
diagnosis for stroke (during and in recovery - 3 total)
-during: CT stat (w/o contrast)
AFTER:
-carotid ultrasound
-lipid panel
initial interventions (ER) for stroke (6)
- ensure patent airway
- SpO2 (give O2 if needed)
- IV
- head CT w/o contrast
- maintain good bp
- anticipate thrombolytic therapy
nursing considerations for pt recovering from stroke in hospital (7)
- increase hob
- keep head midline
- seizure precautions
- NPO until evaluated by speech therapist
- monitor bp
- q1h neuro checks
- glasgow coma scale
measures to prevent stroke for general public (7)
- low sodium diet
- normal body weight
- normal bp
- increase exercise
- no smoking
- limit alcohol
- low fat diet
stroke prevention for pt with TIA or at high risk
antiplatelet therapy (aspirin/clopidogrel)
why would someone receive tPA
drug used to break up blood and restore blood flow to brain with ischemic stroke
tPA considerations for ischemic stroke (3)
- must be given within 4.5 hours
- 2 IVs
- record bp q15 mins
contraindications for tPA (7)
- hemorrhagic stroke
- active bleeding
- surgery
- head trauma
- lumbar puncture
- glucose <50 or >400
- severe HTN
what meds cannot be given for 24 hours after tPA (3)
- aspirin
- warfarin
- heparin
treatment hemorrhagic stroke (4)
- neurosurgery consult
- NO anticoagulants
- manage HTN
- seizure prevention (phenytoin, corticosteroids, diuretics)
