Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NSG 470 > CVA > Flashcards

CVA Flashcards

1
Q

What is a stroke

A

Interruption of blood flow for an extended period of time that does not resolve within 24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Most common type of stroke

A

Ischemic Stroke (85-87%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

True or false stroke is a chronic disease

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Transient Ischemic attack (TIA)

A

Brief episode of stroke like symptoms, however it resolves completely
-Can Last a few minutes to a few hours
-Symptoms completely resolve
-Main idea is that it works as a warning sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How much more likely are you to have a stroke after a TIA

A

9 times

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

TIA treatment

A

-Typically stay for 24-28 hours for observation
-Dual anti-platelets
-Statins
-Tele unit
-Carotid doppler
-Echocardiogram
-Recommend lifestyle changes
-Neuro follow up (even if there are no symptoms)

-Treat it like a stroke with aggressive treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Carotid Doppler

A

Checking for stenosis for TIA or a stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How would a TIA differ a stroke on imaging (MRI/CT)

A

A stroke would be visible occlusion while a TIA would not

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

A patient came into the clinic with facial drooping and weakness on one side of the body, Through CT and MRI the DO concluded that that this was a TIA however after 24 hours, symptoms do not disappear. How would this affect the diagnosis the patient has

A

This would be considered a stroke instead of a TIA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What drugs are given for a TIA

A

anti-plt: Aspirin, Plavix
Statin: Atorvastatin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Echocardiogram TIA

A

Non-invasive
-Looking for a clotting and PFO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Ischemic stroke

A

Blood in brain becomes blocked and cuts off blood supply in the brain resulting in death of brain cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Embolic stroke

A

Ischemic stroke that a clot from another place in the body becomes dislodged and travels to the brain where it gets stuck preventing blood flow to surrounding tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Thrombotic stroke

A

Ischemic stroke that forms as a result of a narrowing of the blood vessel within the brain itself which leads to occlusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Left brain

A

Logic

-Skills like writing, speaking, math, analysis, planning
-Controls the opposite side of the body (Right)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Those with a left brain injury would have issues with

A

Right side hemiparesis
-Aphasia (Issues regarding speaking)
-Would be aware of their limits (Can become angry or frustrated as they are experiencing a loss)
-Would have trouble with written text (Analysis)
-Issues with writing, math
-Memory is intact , remember their skills pre stroke and can be frustrated at this loss of independence

-Recognizing objects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Right brain

A

Creativity

-Their attention span
-Emotions
-Problem solving
-Reasoning (jokes and such)
-Making judgment calls
-Memory recall
-Music and art awareness
-Controls left side of the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Right brain injury would have

A

Left side hemiparesis
-Impairment in creativity
-Confusion of date time and place
-Struggles with recognition of faces or names
-Loss of depth perception
-Trouble staying on topic (attention span)
-Not being able to interpret non-verbal language (Reasoning)
-Lack of awareness or deficits
-Impulsive and poor judgment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

A nurse is caring for a patient who recently experienced a stroke in the right hemisphere. which of the following alterations in functioning would be expected in this patient

A.) Difficulty reading
B.) Inability to recognize family members
C.) Right Hemiparesis
D.) Aphasia

A

B.) Inability to recognize family members

Left brain is responsible for the logical components of function which A,,D fall into. C is incorrect as the weakness in the body is opposite that of where the injury occurred in the brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

BE FAST (stroke)

A

B: Balance (Loss of balance, headache, confusion, dizziness)
E: Eyes (Blurry vision, loss of vision)

F: Facial (Face uneven( Drooping), tongue deviating from midline)
A: Arms are weak, or numb
S: Speech difficulties, slurred speech
T: Timing, call 911 the sooner treatment occurs the better the chances of recovery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

B (BE FAST)

A

Balance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

E (BE FAST)

A

Eyes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

F (BE FAST)

A

Facial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

A (BE FAST)

A

Arms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

S (BE FAST)

A

Speech

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

T (BE FAST)

A

Time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Arm drift

A

Hold out arm in front of patient and have them close their eyes , if one drops and the other stays up its a positive identifier

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Stroke Diagnosis

A

-CAREFUL history, rule out other issues and a physical
-Blood draw (CBC, BMP, Cardiac biomarkers, coagulation studies)
-EKG (Dont delay CT/MRI for it tho)
-CT of head to rule out hemorrhage
-MRI to determine ischemic zone

-Cardiac doppler (Stenosis)
-Echocardiogram
-Cerebral angiography

-Need to differentiate Ischemic and hemorrhagic stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

CT purpose: stroke

A

Rule out bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

MRI purpose: stroke

A

Determine the ischemic zone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Doctor to needle time, stroke

A

1 hour from seeing a doctor to getting TPA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Code Stroke

A

-Get to er within 1 hour of symptoms
-Vitals/EKG 5 min after arriving
-Within 10 min see doctor for neuro eval
-25 min CT scan
-Diagnosis within 45 min after arrival to er

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Treatment; Ischemic stroke

A

-Early intervention is key to prevent infarction of the tissue which is within 1-3 hours
-Pharm treatment
-Thrombectomy: Not everyone is a candidate
-Airway protection
-Blood pressure control (Allow elevated bp)
-Tight diabetic control
-Control of arrhythmias

34
Q

Pharmacological treatment: Ischemic stroke

A

t-PA: Dissolves the clot and increases blood flow
-Dual anti-plt therapy (Aspirin, Plavix)
-Statin
-Anticoagulants
-Anti-epileptic medications as needed

35
Q

TIA is more similar to a hemorrhagic stroke, True or false

A

False

36
Q

Thrombectomy

A

Physical removal of the clot, placement of catheter and then it is used to grab the clot from the blocked artery

-Done after patient has received t-PA and within six hours of acute stroke symptoms

37
Q

Ischemic stroke treatment: Airway control

A

Supplemental O2
-Prevent partial airway obstruction, aspiration pneumonia
-May need intubation for airway control

38
Q

Number one cause of death besides neurologic for those with ischemic strokes

A

Aspiration pneumonia

39
Q

Why allow for hypertension for those experiencing a stroke

A

Hypertension is an increase in blood pressure which may allow for better oxygenation status to areas of the brain that would be affected by the stroke,

-To achieve this they may discontinue the blood pressure medication the patient is on when admitted

40
Q

t-PA major concern

A

Risk of bleeding

-Within the 3 hour window

41
Q

Eligibility criteria t-PA

A

-18+
-No deficits in pre-stroke status
-SBP <185 and diastolic <110
-Not a minor stroke or rapidly resolving symptoms
-No prior intracerebral hemorrhage, AVM aneurysm or tumor
-No GI, GU bleeding in the past 21 days
-No stroke or head trauma in the past 3 months

42
Q

A patient who was diagnosed ischemic stroke, however their symptoms spontaneously resolve are they eligible to t-PA

A

No the symptoms resolved

43
Q

Tissue Plasminogen Activator (t-PA)

A

-Only given for ischemic strokes
-Goal is to be given within 60 min of getting to ED
-Contraindicated for hemorrhagic stroke or more than 3 hours (RISK OF BLEEDING)

44
Q

Nursing interventions t-PA

A

-Monitor for bleeding
-Neuro checks around the clock
-Vitals
-Labs
-Glucose monitoring
-Bed rest to prevent injury
-Avoid unnecessary trauma to the body (Needles, ivs, foley)
-Blood pressure meds needed for those with hypertension
-Most go to icu

45
Q

Why are stroke patients with t-PA on bed rest

A

Threat of falls inducing trauma causing bleeding

46
Q

Hemorrhagic stroke

A

-Weakened blood vessel burst and bleeds into the brain
-Cuts off O2 rich blood supply to the area
-Blood increases pressure in the brain leading to even more dmg

47
Q

Intracerebral hemorrhage

A

Bleed that occurs within the brain itself, usually caused by htn

48
Q

Subarachnoid hemorrhage

A

Bleeding between the brain and the meninges in the subarachnoid space

49
Q

S+S hemorrhagic stroke

A

-Presents similar to ischemic stroke, need CT and MRI to differentiate
- Sudden terrible headache (Thunderclap)
-Immediate loss of consciousness (In severe cases)
-Seizures (more common)
-N+V (Can be both projectile and non projectile)
-Visual disturbances

50
Q

Which stroke has a higher mortality rate ischemic or hemorrhagic

A

Hemorrhagic, it has an initial mortality as high as 50%

Survivability is dependent on the patient

51
Q

Hemorrhagic stroke treatment

A

Goals are to manage the current bleed, allow the brain to recover, minimize future bleeds and prevent complications

-Administer O2
- Bed rest (Avoid even more bleeding)
-Fresh frozen plasma and vitamin K if on blood thinners like warfarin
-Anti-epileptics if seizures occur
-Intermittent pneumatic compression stockings
-Analgesics for head and neck pain
-NEURO EXAM
-If patient is showing worsening neuro exam they might need surgical intervention with craniotomy for aneurism clipping

52
Q

Risk factors for strokes

A

-Htn
-Hyperlip
-Diabetes
-Heavy alc use
-Age
-race
-A-fib
-Carotid stenosis
-Cardiac disease
-TIA history
-Obesity
-Sedentary lifestyle
-Smoking
-AV malformation

53
Q

Nursing assessment, stroke

A

-Careful history, very thorough
-ABC
- Give O2
-Aspiration pneumonia risk
-Neuro checks
-Eye opening and pupil size
-Ability to speak
-I+O
-Seizure precautions
-Bleeding
-Keep BP in parameters, allow permissive hypertension

54
Q

Rehab of a stroke

A

Restore as much function as possible and attain the best quality of life

-Rehab doesn’t cure brain dmg from the stroke but it allows the patient to improve what they have and improve long term outcomes
-Its catered to the patient and their situation, and can vary based on what they need to become independent

55
Q

Major goals of Rehab

A

Prevention of aspiration pneumonia
-Improve mobility
-Relive pressire
-Avoidance of shoulder pain
-SELF CARE
-Confidence
-Continence
-Some form of communication
-Prevent joint deformities (Contractures)

56
Q

Forms of rehab

A

PT
OT
Speech language

57
Q

T/F rehab has to be done by a specialist

A

False the nurse should contribute to start early interventions with the patient

58
Q

Hemiplegia

A

Paralysis on one side of the body (In strokes its the opposite to the side of the brain affected)

59
Q

Hemiparesis

A

One side of the body is weaker than the other

60
Q

Dysphagia

A

Trouble swallowing

61
Q

Paresthesias

A

Pain, tingling or prickling sensation that can occur after a stroke in the weakened or paralyzed limbs

62
Q

Disabilities post stroke: Sensory disturbances

A

Loss of ability to feel touch, pain, temp, or position
-Paresthesias
- Urinary Incontinence

63
Q

Disabilities post stroke: Aphasia

A

-Expressive
-Receptive
-Global aphasia

64
Q

Expressive aphasia

A

Can cant form words, however they can understand what you are saying

Allow them time to speak

65
Q

Receptive aphasia

A

Have issues receiving information, have trouble understanding words as a result

Use short direct phrases

66
Q

Global Aphasia

A

Both receptive and expressive aphasia, most severe form

-Cannot understand language or use it to convey thoughts

67
Q

Disabilities post stroke: memory and thinking

A

-Learning
-Planning
-Comprehension of meaning
-Engage in complex mental activities
-Deficits in short term memory affecting ability to follow long instructions

68
Q

Disabilities post stroke: Emotional disturbances

A

-Fear
-Anxiety
-Sadness
-Frustration
-Anger

-Feel a sense of grief to physical and mental losses

69
Q

Most common mental illness for stroke survivors

A

Depression

70
Q

Dysphagia mgmt:

A

-Swallow studies
-Thickened liquids
-Mechanical soft diets
-Assist with feed
-Tuck chin
-Remove distractions ( have them focus on eating)
-Be patient

71
Q

Aphasia mgmt

A

-Remove distractions
-Be patient
-Repeat and rephrase
-Speak clearly and unhurried

72
Q

Receptive aphasia mgmt

A

-They dont understand what we are saying

-Use shot phrases and simple details
-Use gestures

73
Q

Expressive Aphasia mgmt

A

-They know what we are saying but are having trouble responding with their own words

-Be patient
-Ask one question ask a time
-Communication board
-Ask questions that proct a short response

74
Q

Hemianospia

A

Half of vision is gone, they can see other part

75
Q

Hemianopsia mgmt

A

-Place objects within vision
-Injury prevention
-Approach patient from within vision
-Instruct and remind them to turn head to compensate for loss of vision
-Have someone evaluate driving ability

76
Q

Long term stroke complications

A

–Aspiration pneumonia
-Skin breakdown
-UTI
-Complications of immobility
-Deconditioning
-Bowel and bladder dysfunction

77
Q

T/F once you have a stroke you wont have another for the rest of your life

A

False you are more likely to have one now

78
Q

A nurse is caring for a client who has experienced a right hemispheric stroke. Which of the following are expected findings? (Select all that apply):

A.) Impulse control difficulty
B.) Left hemiplegia
C.) Loss of depth perception
D.)Aphasia
E.) Lack of situational awareness

A

A
B
C
E

79
Q

A nurse is caring for a patient with left homonymous hemianopsia. Which of the following is an appropriate nursing intervention?

A.)Teach the patient to scan to the right to see objects on the right side of her body.
B.)Place the bedside table on the right side of the bed.
C.)Orient the patient to the food on her plate using the clock method
D.)Place the wheelchair on the patient’s left side

A

B.)Place the bedside table on the right side of the bed.

80
Q

A nurse is planning care for a patient who has dysphagia and a new dietary prescription. Which of the following should the nurse include in the plan of care? Select all that apply:
A.)Have suction equipment available
B.) Feed the client thickened liquids
C.) Place food on the unaffected side of the client’s mouth
D.) Assign an assistive personnel to feed the patient slowly
E.) Teach the patient to swallow with the neck flexed

A

A
B
C
E

81
Q

A nurse is caring for a patient who has global aphasia (both receptive and expressive). Which of the following should the nurse include in the patient’s plan of care? Select all that apply:
A.) Speak to the patient at a slower rate
B.) Assist the patient to use flash cards with pictures
C.) Speak to the patient in a loud voice
D.) Complete sentences that the patient can not finish
E.) Give instructions one step at a time

A

A
B
E

82
Q

A nurse is assessing a patient who has experienced a left-hemispheric stroke. Which of the following is an expected finding?
A.) Impulse control difficulty
B.) Poor judgement
C.) Inability to recognize familiar objects
D.) Loss of depth perception

A

C

NSG 470 (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions