Chapter 6 - Acquired Brain Injury Flashcards
Stroke is also known as:
Cerebrovascular accident, which occurs when blood supply to the brain is disrupted.
Ischaemic stroke -
Due to a blocked artery can be caused by either an emboli or a thrombus.
Haemorrhaging stroke -
Bleed out in brain, blood vessel ruptured.
Risk factors for stroke include:
Hypertension Obesity Cigarette smoking Diet high in cholesterol Alcohol Lack of exercise Diabetes Atrial fibrillation
APPT is a clothing measure of bloods and stands for:
Activated partial thromboplastin time
A normal GCS is:
15
Stroke should be considered a medical emergency as:
Diagnosis and treatment with tPA needs to occur within four and a half hours from onset of symptoms
A thrombus which has broken loose and is moving with the blood flow is called:
An embolism
Atheroma is:
Fatty plaque on the wall of an artery
A stroke-in-evolution is:
A thrombotic stroke that occurs rapidly but then progresses slowly over 2-3 days.
The immediate treatment for a stroke includes:
Receiving a thrombolytic in the Emergency Department once a CT scan has been done.
Which is the most important goal in the immediate phase of acute stroke care?
Minimal damage to the penumbra and re-establish perfusion as quickly as possible.
Difference between the systolic and diastolic pressure is called the:
Pulse pressure
4 common cues during stroke :
Pattern of breathing
Headache
Nausea/vomiting
Presence of papilloedema
List three factors that can impair cerebral auto regulation:
- Increase arterial pressure
- Increased hydrogen ions from increased CO2
- A fall in Pa02
What are the two major arteries supplying the brain?
Cerebral and vertebral
Cushings triad is associated with:
Raised intracranial pressure
Three parameters that form cushings triad:
- Raised pulse pressure
- Decreased pulse
- Abnormal breathing pattern
Mannitol is an osmotic diuretic. It would be most likely to be given for:
Cerebral oedema
The rigid cranial cavity contains three non-compressible elements:
- The brain 80%
- CSF 8%
- Blood 12%
The Monroe - Kellie hypothesis is when:
Any of the 3 components increases, the volume of the others must decrease to maintain equilibrium. (Brain, CSF, Blood)
Normal intracranial pressure is:
0-10mmHg
3 signs which usually are not causative of confusion and altered level of consciousness:
- Hypertension
- Hypo/hyoerkalemia
- Hyponatraemia
Which of the folllowing is not a risk factor for developing artherosclerosis?
- Male
- Diabetes
- Smoking
- High HDL level
- High dietary fat intake
High HDL level
Early warning signs of altered level of consciousness include:
- GCS<12
- A drop in GCS by 2 points
- BGL 1-2.9mmol/L
- Any seizure
Late warning signs of altered level of consciousness are:
- GCS < or = 8
- Unresponsive to verbal command
- BGL < 1 mmol/L
Hemiplegia:
Paralysis of the left or right half of body
Aphasia/dysphasia
Difficulty speaking/incomprehensible speech or inability to understand speech
Dysarthria
Difficulty speaking/pronouncing words
Hemianopia
Loss of half of the visual field of one or both eyes
Unilateral neglect
Unaware of and inattentive to one side of the body
Agnosia
The inability to recognise previously familiar objects
Diplopia
Unilateral or bilateral double vision
Dysphagia
Difficulty swallowing
A stroke patient having decreased mobility increased the risk of:
DVT - Deep vein thrombosis
When monitoring for thrombophlebitis, limbs should be assed for:
Increased warmth, increased redness and increased calf circumference
Hypothermia may develop in a stroke patient due to damage to the:
Hypothalamus
Stroke patients who have dysphagia May become:
Malnourished
Chest physiotherapy -
To prevent chest infections such as aspiration/pneumonia.
Anti-embolic stockings and early mobilisation-
To prevent thrombophlebitis and contractures
Monitor vital signs and respiratory status-
To detect early developing complications such as pneumonia, bleeding
Assess for warmth, redness and increase size of calves -
To monitor development of thrombophlebitis
Face patient, speak slowly and allow for answers -
To maintain patient dignity and decrease frustration with communication
Encourage fluids and high fibre diet -
To prevent constipation
