Chapter 18 - Altered Mental Status, Stroke, and Headache

Question 1

a network of specialized nerve cells within the brainstem that controls states of arousal and consciousness including wakefulness, attentiveness, and sleep

Answer 1

reticular activating system (RAS)

Question 2

an unconscious state in which the Pt does not respond to painful stimuli is referred to as a ______.

Answer 2

coma

Question 3

______ causes of AMS
brain tumor
hemorrhage in the cranium but outside of the brain
hemorrhage in the brain tissue
direct brain tissue damage from trauma to the brain
degenerative disease of the brain
brain abscess or infection

Answer 3

structural causes of AMS

Question 4

\_\_\_\_\_\_ causes of AMS
severe hypoxia or anoxia (reduced or no 02)
abnormal BGL
liver failure
kidney failure
poisoning

Answer 4

toxic-metabolic

Question 5

S/S
obvious signs of trauma: DCAP-BTLS
abnormal resp pattern
increased or decreased HR
unequal pupils
high or low BP
discoloration around eyes (late sign)
discoloration behind ears (late sign)
pale, cool, clammy
decorticate or decerebrate

Answer 5

AMS - trauma

Question 6

S/S
abnormal resp pattern 
dry or moist skin
cool or hot skin
pinpoint, midsize, dilated, or unequal pupils
stiff neck
lacerations to the tongue - seizure bite
high systolic BP and low HR
loss of bladder/bowel
abnormally high or low BGL

Answer 6

AMS - nontraumatic or medical condition

Question 7

any deficiency in the nervous systems functioning, typically exhibited as a motor, sensory, or cognitive deficit

Answer 7

neurological deficit

Question 8

S/S
slurred speech
absent speech
paralysis
weakness
numbness

Answer 8

neurological deficit

Question 9

a sudden disruption in blood flow to the brain that results in brain cell damage. blood flow might be interrupted by a ruptured artery or blocked by a clot or other foreign matter in an artery that supplies the brain

Answer 9

stroke or cerebrovascular accident or CVA

“brain attack”

Question 10

a stroke caused by a cot obstructing a blood vessel in the brain, resulting in an inadequate amount of blood being delivered to a portion of the brain distal to the blocked vessel

Answer 10

ischemic stroke

Question 11

a stroke caused by rupture of a blood vessel in the brain that allows blood to leak and collect in or around the brain tissue

Answer 11

hemorrhagic stroke

Question 12

a clot that develops at the site of occlusion

Answer 12

thrombus

Question 13

the process of clot formation is called

Answer 13

thrombosis

Question 14

a type of ischemic stroke caused by a stationary clot that forms in and blocks a cerebral artery

Answer 14

thrombotic stroke

Question 15

a type of ischemic stroke caused by plaque or other material that lodges in and blocks a cerebral artery

Answer 15

embolic stroke

Question 16

bleeding on the surface of the brain

Answer 16

subarachnoid

Question 17

bleeding within the brain

Answer 17

intracerebral

Question 18

brief, intermittent episode with stroke-like symptoms that typically disappear within minutes, but usually last no longer than 1 hr., caused by an oxygen deficit in the brain tissue and are often a precursor to a stroke

Answer 18

transient ischemic attack

Question 19

S/S scale:
facial droop by having Pt show teeth
arm drift (closed eyes supine arms out)
abnormal speech (you cant teach an old dog new tricks)

Answer 19

cincinnati prehospital stroke scale CPSS

Question 20

S/S scale:
age>45
history of seizures or epilepsy
duration of symptoms
wheelchair or bedridden pt
BGL

Answer 20

LA prehospital stroke scale LAPSS

Question 21

stroke pt physical assessment considerations
1
2
3

Answer 21

look up, smile, and show teeth
compare grip strength of upper extremities
assess arm strength for drift weekness

Question 22

S/S
possible seizures
loss of bowel or bladder
arm drift
paralysis or weakness to one or both sides of body
drooping eyelid and mouth on one side of face
severe headache
decreased consciousness
change in personality
pupils unequal in size
loss of vision, dimness, or double vision
difficulty speaking or slurred speech
inability to speak
nausea or vomiting
sudden weakness or paralysis of face, arm, or leg

Answer 22

stroke