CVA

Question 1

What are the two types of ischemic strokes

Answer 1

Thrombotic and embolic

Question 2

Three types of hemorrhagic strokes

Answer 2

Aneurysm, hypertension, arteriovenous malformation

Question 3

What is the most common kind of stroke

Answer 3

Thrombotic stroke, ruptured plaque with clot formation

Question 4

In an embolic stroke where does the source of the emboli usually come from

Answer 4

The heart, possibility of history of a fib, heart valve disease or endocarditis. Second most common cause of a stroke

Question 5

What is the most common cause of a hemorrhagic stroke

Answer 5

Hypertension, has poor prognosis

Question 6

Modifiable risk factors for a stroke

Answer 6

Hypertension, heart disease, diabetes, smoking, obesity, sleep apnea, metabolic syndrome, lack of physical exercise, poor diet, drug and alcohol use.

Fixing one thing, such as obesity, can usually help reduce other risk factors

Question 7

Transient ischemic attack

Answer 7

Transient episode of neurological dysfunction due to ischemia. No acute infarction on brain. Symptoms usually last less than one hour

Question 8

The patient has a TIA what is the likelihood they will have a CVA

Answer 8

No way to predict outcome. 1/3 do not have another event, 1/3 have more TIAs, 1/3 progress to a CVA

Question 9

Clinical manifestations of stroke

Answer 9

Motor function impairs mobility, respiratory function, swallowing, speech, gag reflex, self-care abilities, akinesia, changes in muscle tone, altered reflexes, aphasia, dysphasia, dysarthria, hard time controlling emotions, impaired memory or judgment, spatial perceptual problem, temporary alterations in bowel and bladder, homonymous hemianopsia

Question 10

Akinesia

Answer 10

Lots of voluntary movement

Question 11

Different types of aphasia

Answer 11

Receptive aphasia is loss of comprehension. Cannot understand what other people are telling you.

Expressive aphasia is inability to produce language, or an ability to say what you were trying to say.

Global aphasia is the total inability to communicate

Question 12

Dysphasia and dysarthria

Answer 12

Dysphasia is impaired ability to communicate and used interchangeably with a fashion. Dysarthria is garbled speech

Question 13

Agnosia

Answer 13

Loss of ability to identify objects

Question 14

Apraxia

Answer 14

Inability to perform familiar movements on command

Question 15

Homonymous hemianopsia

Answer 15

Blindness occurs in same half of visual field of eye

Question 16

Management of modifiable risk factors

Answer 16

Healthy diet, weight control diet exercise, stop smoking, limit alcohol, blood pressure management, routine health assessments

Question 17

Management of modifiable risk factors

Answer 17

Healthy diet, weight control diet exercise, stop smoking, limit alcohol, blood pressure management, routine health assessments

Question 18

Preventative drug therapy

Answer 18

Antiplatelets, ASA

Question 19

Surgical interventions for patients with TIAs due to carotid disease

Answer 19

Stenting, transluminal angioplasty, carotid endarterectomy

Question 20

Stroke unit care

Answer 20

Patients with acute strokes have better outcomes when admitted to hospitals with specialized units for strokes

Question 21

Interventions

Answer 21

fibrinolytic therapy, Endo vascular interventions

Question 22

Acute nursing care for ischemic stroke

Answer 22

ABCs, Baseline neurological assessment, blood pressure might be slightly elevated after stroke, control fluid and electrolyte balance, manage ICP, TPA, may use a Staten. After stabilization patient may be placed on anticoagulants and platelet inhibitor’s

Question 23

Treating a hemorrhagic stroke

Answer 23

AB Cs, ICP management, surgical interventions such as evacuation of hematomas, resection and or radiosurgery, clipping or coiling of the aneurysm. Procedure chosen based on cause of stroke