Chapter 45 Flashcards
Two types of strokes?
ischemic and hemorrhagic
Couse of Intercerebral stroke?
severe hypertension, could be caused by cocaine use
Common origin of an embolus from an embolic stroke?
the heart, commonly found with patients who have A fib
What is Homonymous Hemiopsia?
field cut in vision, approach from unaffected side and remind them to scan their environment
What is an aneurysm?
blister along artery
What is an Anterio-venous infarction?
absence of capillary network which normally displaces pressure, without it the pressure raises too high and ruptures
Causes of Subarachnoid hemorrhage?
aneurysm or anterio-venous infarction
What is a subarachnoid hemorrhage?
bleeding into the subarachnoid space
5 most common symptoms of a stroke
- Sudden confusion, trouble speaking, or understanding others
- Sudden numbness or weakness of the face, arm, or leg
- Sudden trouble seeing in one or both eyes
- Sudden dizziness, trouble walking, loss of balance
- Sudden severe headache with no known cause
Cognitive changes seen with stroke patients
- Denial of illness
- Spatial and proprioceptive dysfunction
- Impaired memory, judgment
- Inability to concentrate and attend to tasks
Proprioception
sense of body position in space
Symptoms of Right Hemispheric Stroke?
- Proprioception – sense of body position in space
- Personality changes – impulsivity and poor judgement
- Disorientation
- Impaired sense of humor – Becky/Emma
- Inability to hear tonal variations – Evan doing karaoke
- Left visual field impairment
Apasia
inability to comprehend language
Alexia or dyslexia
reading problems
Agraphia
difficulty writing
Acalculia
not Asians
Symptoms of Left Hemispheric strokes
- Aphasia – inability to comprehend language
- Alexia or dyslexia – reading problems
- Agraphia – difficulty writing
- Acalculia – inability to do math
- Right visual field impairment
Equation for Cerebral Perfusion Pressure
MAP - ICP = CPP
Normal CPP
60 to 100
Normal ICP
5 to 15
What do you assess when you do a neuro assessment?
- Vitals
- Motor strength
- Cranial nerves
- Pupil assessment
- Glasgow coma scale
Worst score on the Glasgow coma score?
15
Early symptoms of increased ICP?
- Change in LOC
- Decreased motor function
- Headache
- Vomiting
- Ocular signs
Decorticate posture
arms flexing towards the spinal cord
Decerebrate posture
arms pronating and extending
Late symptoms of ICP
- posturing
- hyperthermia
- vitals change
Cushing’s Triad
bradycardia
irregular respirations
hypertension
widening BP pulse pressure
Broca’s aphasia
Unable to convert thoughts to meaningful language, outburst of profa F#%$ S*&^T, aware of deficits
Wernicke’s aphasia
Unable to understand spoken and written word
Dysarthria
tongue and facial weakness
Subarachnoid precautions
– decrease stimuli, head and neck alignment, avoid hip flexion, no enemas!
NIHSS stroke scale
low good, high bad
Teaching to avoid neglect…
Remind pt to touch both sides of body
Dress affected side first
Remind them of safety issues, put safety procedures in effect (bed alarms, etc)
