Concepts Exam #2 (Ch. 45) Flashcards
Brain Attack
AKA - Stroke, called this by the National Stoke Assoc., is a medical emergency, and it should be treated ASAP to reduce permanent disability.
Ischemic Stroke
caused by the occlusion of a cerebral artery by either a thrombus or embolus.
Thrombotic Strokes
account for more than half of all strokes and are assoc. with development of atherosclerosis in either intracranial or extra cranial arteries (carotid arteries).
Embolic Stroke
Caused by a thrombus that break off from one area and travel to cerebral arteries via carotid arteries.
Critical Rescue - Stroke patient should be assessed within 10 minutes of arrival.
Priority is assessment of ABCs.
Hemorrhagic Stroke
2nd Major Class of stroke - Vessel integrity is interrupted and bleeding occurs into the brain tissue or into the subarachnoid space.
AVM
Arteriovenous Malformation - uncommon abnormality that occurs during embryonic development. Abnormal vessels may rupture, causing bleeding into the intracerebral tissue or spaces.
NIH (National Institutes of Health Stroke Scale)
Valid and reliable assess tool that nurses complete ASAP after patients arrive in ED.
Thrombolytic Therapy
Give within 3-4 hours of stroke symptoms. AKA Fibrinolytic Intravenous Therapy. It’s goal is to dissolve the cerebral artery occlusion and reestablish blood flow and prevent cerebral infarction.
Alteplase
The only approved drug to treat acute ischemic stroke.
Cerebral Aneurysm
Abnormal ballooning or blister along a normal artery, it develops in a weak spot on the artery wall.
Cushing’s Triad
a sign of increased intracranial pressure. It is the triad of: 1. Hypertension, 2. Bradycardia, 3. Widening Pulse Pressure (increase in the difference between systolic and diastolic pressure over time)
tPA dose for Acute CVA
0.9mg/kg IV, not to exceed 90mg total dose - administer 10% of the total dose as an initial IV bolus over 1 minute and the remainder infused over 60 minutes.
tPA dose
Give ASAP but within 3 hours after onset of symptoms, monitor BP during and post administration. Discontinue if pretreatment INR is greater than 1.7 or the aPTT is elevated.
Romberg’s Test
tool to diagnose sensory ataxia (Loss of control of bodily movement, a gait disturbance caused by abnormal proprioception involving info about the location of joints. Measures degree of vertigo and head trauma. Used for 150 years.
