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Med Surg > CVA > Flashcards

CVA Flashcards

1
Q

Two types of stroke

A

Ischemic and hemorrhagic

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2
Q

Risk factors of stroke

A

75-85, African Americans and Asians, carotid stenosis, cocaine use, OC + smoking, sickle cell disease, chronic migraines, cardiomyopathy, sleep apnea, lupus, RA

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3
Q

Ischemic stroke

A

vascular occlusion, caused by thrombus or embolus, also cocaine use and migraine

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4
Q

Thrombotic CVA

A

clot forms within the vessel, caused by carotid artery stenosis or atherosclerotic plaques

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5
Q

Embolic CVA

A

clot forms in a proximal site then travels to the brain, caused by afib, valvular heart disease, fat emboli from long bone fractures

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6
Q

CVA Symptoms

A

Numbness or weakness of face, arm, leg; confusion, alteration in mental status, trouble speaking or understanding speech, dysphagia, diplopia, loss of peripheral vision, homonymous hemianopia, sudden, severe headache, ataxia, cognitive impairment, emotional outbursts/ lability

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7
Q

Hemiplegia

A

1 sided paralysis

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8
Q

Hemiparesis

A

1 sided weakness

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9
Q

Dysphasia

A

impaired speech

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10
Q

Aphasia

A

inability to express self (expressive) or understand others (receptive)

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11
Q

homonymous hemianopia

A

loss of 1/2 of visual field

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12
Q

ataxia

A

unsteady gait, staggering gait, trouble walking, loss of balance or coordination, dizziness

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13
Q

Signs of a stroke

A

balance, eyes, face, arm, speech, time

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14
Q

Expressive Aphasia

A

left frontal lobe (Broca), short phrase speech, omit words, trouble finding the correct words, understand speech of others but cannot adequately express themselves, often aware of difficulties, can become frustrated

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15
Q

Receptive aphasia

A

left temporal lobe (Wernicke), difficulty understanding written and spoken language, difficulty following directions, unaware of speech issues

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16
Q

TIA

A

temporary neurlogic ischemia, symptoms last less than 60 mins, sudden loss of motor, sensory or visual function, brain imaging shows no ischemia (but not multiples), often serves as a warning sign of impending stroke (15%)

17
Q

Diagnostic studies for Ischemic CVA

A

CT scan w/o IV contrast, 12 lead ekg, echo/ tee, carotid US, MRI/MRA, cerebral angiography, illicit drug use test

18
Q

Ischemic CVA Prevention

A

no smoking, exercise (30-40 mins, 3-4x week), healthy weight, healthy, low fat diet, modest alcohol consumption, control BP, daily low dose aspirin (only for 1st)

19
Q

General treatment of ischemic CVA

A

anticoagulants, antiplatelets, ace inhibitors, diuretics, statins

20
Q

Immediate treatment for CVA

A

t-PA (or heparin/ enoxaparin)

21
Q

Invasive treatment for ischemic CVA

A

mechanical embolectomy (Penumbra device, trevo, merci retriever), carotid endarterectomy

22
Q

ischemic stroke nursing care

A

thorough neuro assessment… (Slide 26)

23
Q

Hemorrhagic CVA

A

bleeding into brain tissue or subarachnoid space

24
Q

Hemorrhagic CVA causes

A

cerebral aneurysm (dilation), AVM (tangling of the veins)

25
Q

AVM

A

tangling of the arteries/veins, congenital, leads to dilation of cerebral a/v that rupture, most common cause of hcva in younger patients, most common cause is HTN

26
Q

hCVA

A

similar to iCVA plus- n/v, possible seizure development, sudden change in consciousness or sudden loss, severe headache, nuchal rigidity, visual disturbances, tinnitus, dizziness, increased ICP, coma and/or death may occur

27
Q

hCVA Diagnosis

A

CT scan, MRI, Cerebral angiography

28
Q

hCVA treatment

A

number one goal is minimize and prevention
bleeding- bedrest, correct INR, DTI reversals
treat seizures, prevent DVTs, analgesics, control fever and BP

29
Q

hCVA surgical management

A

Craniotomy, aneurysm clipping

30
Q

hCVA endovascular treatment

A

coils- occludes blood flow to treat aneurysm, admin of thrombolytic

31
Q

complications of hCVA

A

cerebral hypoxia, vasospasm, ICP, HTN (slides 35 and 36 for how to treat)

32
Q

CVA nursing care

A

thorough and frequent neuro checks is key (slide 37)

33
Q

Post stroke care

A

assistance with ADLs, adaptive devices, ST,PT,OT, swallowing eval, visual retraining, supportive services, home health care, family support

34
Q

Pt with swallowing issues

A

upright position, no straws, dysphagia diet, ST and swallowing eval, thickened liquids

Med Surg (15 decks)

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