CVA Flashcards
1
Q
What does CVA stand for?
A
Cerebrovascular Accident
Also referred to as a stroke.
2
Q
What is a sudden loss of brain function due to?
A
Loss or disruption of blood supply to part of the brain
This can lead to various neurological deficits.
3
Q
What are the results of a CVA?
A
Functional CNS abnormalities
These abnormalities can vary depending on the area of the brain affected.
4
Q
CVA results in _______ due to loss of blood supply.
A
functional CNS abnormalities
5
Q
CVA is a joint commissioned care measure aid measure and national standard of care meaning ->
A
specific standard set of guidelines on how we treat, assess, and educate patients post-stroke
6
Q
Goal of CVA joint commissioned core measure and national standard of care
A
Improve quality of stroke patients and set guidelines
7
Q
What is the consequence of lack of blood supply?
A
Lack of oxygen leading to death of tissue
This highlights the critical role of blood supply in maintaining tissue viability.
8
Q
What functional changes can occur due to a stroke?
A
Thinking, sensation, movement, action
These changes can significantly impact daily life and require rehabilitation.
9
Q
What does the phrase ‘time is brain’ imply?
A
The urgency of treating strokes to minimize brain damage
This emphasizes the importance of rapid response in stroke management.
10
Q
What is the location of the Anterior Cerebral Artery?
A
On top of the brain
Supplies blood to the anterior portions of the brain.
11
Q
What area does the Middle Cerebral Artery supply?
A
Middle brain tissue
Supplies blood to the lateral aspects of the cerebral hemispheres.
12
Q
Where is the Posterior Cerebral Artery located?
A
Bottom of the brain
Supplies blood to the posterior portions of the brain.
13
Q
What is ischemic stroke caused by?
A
From a thrombosis or embolism
14
Q
Define thrombosis.
A
Blood clot formed in blood vessel due to blockage
15
Q
What is an embolism?
A
Blood clot formed somewhere else in the body that breaks loose and travels to the brain
16
Q
What causes a hemorrhagic stroke?
A
From an aneurysm, where a weakness in a blood vessel in the brain balloons out and can burst due to HTN
17
Q
What percentage of people who have strokes can activate the EMS system?
A
Only 30%
18
Q
How should a stroke be treated?
A
As a medical emergency whether bystander or medical professional
19
Q
What does the brain need for its function?
A
Constant flow of blood supply
20
Q
Fill in the blank: The brain cannot store _______ or glucose.
A
O2
21
Q
What is atherosclerosis?
A
A condition that decreases cerebral perfusion, hardening and thickening of blood vessels
22
Q
What is the primary effect of atherosclerosis on the brain?
A
Narrowing of blood vessels leading to ischemia, hypoxia, and hypoglycemia
23
Q
What is the outcome of cerebral ischemia?
A
Cerebral infarction
24
Q
What causes thrombolic strokes?
A
Atheromatous plaques that occlude cerebral arteries
25
What causes embolic strokes?
Dislodged thrombi (emboli) that occlude cerebral arteries
26
What causes hemorrhagic stroke?
Cerebral arterial wall rupture
27
What conditions are related to hemorrhagic stroke?
* Hypertension
* Cerebral aneurysms
28
What happens when blood bleeds into cerebral tissues?
Increases intracranial pressure (ICP) and causes tissue anoxia
29
Fill in the blank: Atherosclerosis leads to _______ in the brain.
ischemia
30
True or False: Thrombolic strokes are caused by dislodged thrombi.
False
31
True or False: Hemorrhagic stroke can result from hypertension.
True
32
What is the highest risk factor for both types of strokes?
HTN
## Footnote
HTN stands for hypertension, which significantly increases the risk of both ischemic and hemorrhagic strokes.
33
What is the primary cause of ischemic stroke?
Thrombotic plaque
## Footnote
Thrombotic plaque is associated with the buildup of atherosclerotic plaque in arteries.
34
What does atherosclerosis stenosis refer to?
Narrowing of an artery due to atherosclerotic plaque
## Footnote
This plaque is made up of fatty deposits, cholesterol, and other substances.
35
List the risk factors for ischemic stroke.
* Hypertension
* Diabetes
* High cholesterol
* Smoking
* Sedentary lifestyle
* Obesity
* Excessive alcohol consumption
* Certain heart conditions
* Prior stroke history
## Footnote
These factors contribute to the likelihood of experiencing an ischemic stroke.
36
What is a key characteristic of hemorrhagic stroke?
Caused by bleeding in the brain
## Footnote
Hemorrhagic strokes can lead to significant complications due to the pressure from the bleeding.
37
What are key risk factors for hemorrhagic stroke?
* High blood pressure
* Older age
* Blood vessel abnormalities (aneurysms, arteriovenous malformations)
* Smoking
* Excessive alcohol consumption
* Certain medical conditions (like diabetes)
## Footnote
These factors increase the risk of bleeding in the brain.
38
What is a primary cause of embolic stroke?
Atrial Fibrillation
## Footnote
Atrial Fibrillation leads to improper blood ejection from the heart chambers, causing blood to sit and form clots.
39
How do blood clots travel in the case of atrial fibrillation?
Clots can travel to the lungs or brain
## Footnote
This can result in an embolic stroke.
40
What heart condition can lead to an embolic stroke?
Heart malformation
## Footnote
Specifically, a hole in the heart can cause blood clots to form and travel to the brain.
41
Fill in the blank: If blood is not ejecting correctly from the heart, blood clots can form and travel to the _______.
brain
42
True or False: Atrial Fibrillation causes blood to be ejected correctly from the heart.
False
## Footnote
Atrial Fibrillation results in improper ejection of blood.
43
What happens when blood clots travel to the brain?
It creates a stroke
## Footnote
This is a critical outcome of embolic strokes.
44
What is a hemorrhagic stroke also known as?
Arterial 'blowout'
## Footnote
Hemorrhagic stroke occurs when an artery in the brain breaks open.
45
What are the primary causes of a hemorrhagic stroke?
HTN or aneurysm
## Footnote
HTN refers to hypertension, and an aneurysm is a weakened area in an artery wall.
46
What happens to an artery in the brain during an aneurysm?
The artery balloons out and breaks open
## Footnote
This leads to bleeding in the brain.
47
What is a consequence of bleeding in the brain from a hemorrhagic stroke?
Causes pressure in the brain
## Footnote
The skull does not allow the brain to swell, leading to tissue death.
48
What is a hallmark symptom of a hemorrhagic stroke?
Sudden onset headache (worst ever)
## Footnote
This headache does not go away and may feel like the brain is being split open.
49
Fill in the blank: A hemorrhagic stroke causes pressure which leads to _______.
brain tissue death
## Footnote
This occurs because the skull limits the brain's ability to swell.
50
True or False: Aneurysms can lead to hemorrhagic strokes.
True
## Footnote
An aneurysm is a significant risk factor for hemorrhagic strokes.
51
What is the consequence of bleeding in the brain?
Loss of blood flow = ischemia -> infarction/necrosis - death of brain tissues
## Footnote
Ischemia refers to insufficient blood supply to tissues, leading to potential tissue death.
52
What are the locations of intracranial hemorrhages?
* Subdural
* Intracerebral
* Epidural hematoma
## Footnote
These locations indicate where bleeding can occur within the layers of the brain.
53
Fill in the blank: Bleeding puts pressure in the brain and loss of tissue perfusion leads to _______.
ischemia
54
True or False: Infarction in the brain is a result of adequate blood flow.
False
## Footnote
Infarction occurs due to a lack of blood flow, leading to tissue death.
55
What does an intracranial hemorrhage result in?
Loss of blood flow leading to ischemia and possibly infarction/necrosis
## Footnote
Intracranial hemorrhages can occur in various locations, each with its own implications.
56
What does TIA stand for?
Transient Ischemic Attack
57
What is a TIA?
Temporary interruption of blood flow to the brain
58
What does a TIA often indicate?
Raises risk for CVA in 2-5 years
59
How long does a TIA typically resolve?
Usually within 24 hours
60
What are common risk factors for TIA?
* HTN
* Atherosclerosis
* Cardiac disease
* Atrial fibrillation
* Cerebral aneurysm
* Diabetes Mellitus
61
True or False: A TIA is a permanent condition.
False
62
Fill in the blank: A TIA resolves within a few _______.
minutes to hours
63
What should you do if at high risk of stroke?
Need to talk to provider immediately
## Footnote
Immediate consultation with a healthcare provider is crucial for individuals identified as high risk for stroke.
64
What actions should be taken with caution risk for stroke?
Make changes now:
* Quit smoking
* Lower cholesterol
* Decrease weight
* Get BP under control
* Get afib under control
* Get DM under control
* Exercise
## Footnote
These lifestyle modifications can significantly reduce the risk of stroke.
65
What is the lead factor for both types of stroke?
HTN
## Footnote
HTN stands for hypertension.
66
How does smoking affect the risk of stroke?
Doubles risk for ischemic stroke and triples risk for subcranial hemorrhage
## Footnote
Smoking is a significant modifiable risk factor.
67
What condition doubles the risk for stroke in individuals with uncontrolled blood glucose?
DM
## Footnote
DM stands for diabetes mellitus.
68
What is the relationship between weight and stroke risk?
Direct link between obesity and stroke
## Footnote
Obesity is a modifiable risk factor.
69
What lifestyle change can reduce stroke risk by 30 minutes of activity per day?
Exercise
## Footnote
Regular physical activity is crucial for reducing stroke risk.
70
What is the direct link between alcohol and stroke?
Alcohol use increases stroke risk
## Footnote
Moderation is key to lowering this risk.
71
What does AFib stand for?
Atrial fibrillation: Risk for stroke
## Footnote
AFib involves disorganized electrical signals in the heart.
72
What is CAD an abbreviation for?
Coronary artery disease
## Footnote
CAD is a significant risk factor for stroke.
73
What are some risk factors of stroke that we can modify?
Medications and lifestyle changes
## Footnote
Modifiable factors include exercise, diet, and smoking cessation.
74
Which ethnicities may have varying risks for stroke?
*African Americans
*Pacific Islanders
*Hispanics
- though some studies show this risk diminishes when demographic and socioeconomic factors are considered.
*South Asians may have higher stroke mortality.
## Footnote
Certain ethnic groups may have higher predispositions to stroke.
75
What does TIA stand for?
Transient Ischemic Attack
76
What is a TIA?
Transient loss of blood flow to the brain resulting in temporary neurologic function (several minutes to 24 hours)
77
What can precipitate a TIA?
Exertion, rising from lying to standing, or strenuous exercise
78
What is the usual outcome after a TIA?
Usually complete recovery
79
What does a TIA warn of?
Impending CVA within 2-5 years
80
How should TIA be treated?
Like a stroke unless ruled out
81
What does TIA indicate about blood pressure?
BP may be sky high
82
What is a CTA of the brain?
CT Angiography, a medical imaging technique that uses X-rays and a special dye to create detailed pictures of the blood vessels in the brain
83
What is the primary use of brain CTA?
Diagnosing and evaluating conditions affecting the brain's blood supply, such as aneurysms, blockages, and blood clots
84
True or False: A TIA lasts longer than 24 hours.
False
85
Fill in the blank: TIA is a warning of impending _______.
CVA
86
What are the symptoms of TIA that are similar to a stroke?
Temporary visual, motor, sensory, speech deficits; confusion
## Footnote
Symptoms of TIA can mimic those of a stroke, indicating a need for immediate medical evaluation.
87
What is a carotid bruit?
A turbulent blood flow from the carotid artery that cuts off blood flow to the brain
## Footnote
A carotid bruit can be detected with a stethoscope and indicates atherosclerosis in the carotid arteries.
88
What causes a carotid bruit?
Turbulent flow of blood in an artery due to either an area of partial obstruction or a localized high rate of blood flow through an unobstructed artery
## Footnote
This abnormal sound can indicate potential cardiovascular issues.
89
What may be needed if a patient has significant atherosclerosis in the carotid arteries?
Carotid endarterectomy
## Footnote
This surgical procedure clears out atherosclerotic tissue to restore blood flow.
90
What can diminished carotid pulses indicate?
Decreased blood flow to the brain
## Footnote
Diminished pulses can be a sign of significant vascular issues.
91
True or False: TIA can cause permanent damage to the brain.
False
## Footnote
TIA symptoms are temporary and do not cause permanent brain damage, unlike a stroke.
92
Fill in the blank: A _______ is generated by turbulent flow of blood in an artery.
bruit
## Footnote
Bruit is also known as a vascular murmur.
93
What is a carotid endarterectomy (CEA)?
A surgical procedure to remove plaque buildup from the carotid arteries
94
What does CEA help improve?
Blood flow and reduce the risk of stroke
95
What is plaque in the context of CEA?
A buildup of fat and cholesterol in the carotid arteries
96
Why is CEA performed?
To remove plaque that narrows the arteries, restricting blood flow and increasing stroke risk
97
How is CEA performed?
An incision is made on the neck, the artery is opened, plaque is removed, and the artery is closed
98
Who typically needs a carotid endarterectomy?
Individuals with carotid artery stenosis and symptoms of reduced blood flow or high stroke risk
99
What happens when blood flow is restored after CEA?
Syncope if the patient stands too quickly and fluctuating blood pressure
100
What can happen if a doctor does not remove 100% of atherosclerosis during CEA?
At risk for re-stroke and may have headaches
101
Fill in the blank: CEA involves surgically removing _______ from the carotid arteries.
plaque
102
True or False: CEA is only recommended for patients with carotid arteries that are completely blocked.
False
103
What does the acronym BE FAST stand for in recognizing stroke signs?
Balance, Eyes, Face, Arms, Speech, Time
## Footnote
Each letter represents a specific sign to look for when assessing a possible stroke.
104
What should you assess regarding 'Balance' when checking for signs of a stroke?
Is the person unsteady on their feet?
## Footnote
Unsteadiness can indicate a problem with coordination or balance, which may be a sign of a stroke.
105
What does 'Eyes' refer to in the context of stroke signs?
Have they lost vision in one or both eyes?
## Footnote
Sudden vision loss can be a critical symptom of a stroke.
106
What facial feature should you examine to check for signs of a stroke?
Does the person's face look uneven?
## Footnote
Asking the person to smile can help identify facial droop, a common sign of stroke.
107
What should you observe about the arms for stroke detection?
Is one arm hanging limp?
## Footnote
Asking the person to put arms straight out and close their eyes can help assess arm drift.
108
What speech-related issue should you listen for when assessing a stroke?
Are they having trouble speaking?
## Footnote
Difficulty in speech may indicate a stroke affecting the language centers of the brain.
109
What action should you take if you observe any signs of stroke?
Call 911.
## Footnote
Immediate medical attention is crucial when stroke symptoms are present.
110
What are the Sudden symptoms related to a stroke?
The Sudden symptoms include:
* Sudden numbness or weakness of the face, arm, or leg
* Sudden confusion, trouble speaking, or understanding
* Sudden trouble seeing in one or both eyes
* Sudden trouble walking, dizziness or loss of balance/coordination
* Sudden severe headache
## Footnote
These symptoms are critical indicators of a potential stroke.
111
What should you do if you suspect someone is having a stroke?
Call the designated stroke team at the hospital
## Footnote
Most hospitals have a specific team for stroke emergencies.
112
What does ABC stand for in nursing?
Airway, Breathing, and Circulation
## Footnote
ABCs are used as a rapid assessment method in emergency situations to prioritize patient care.
113
What is the first component of the ABCs?
Airway
## Footnote
Nurses assess for a clear, unobstructed airway to ensure adequate oxygen intake.
114
What should nurses assess when evaluating Breathing?
Respiratory effort, rate, and oxygen saturation
## Footnote
They may need to administer supplemental oxygen or assist with ventilation.
115
What parameters are assessed under Circulation?
Heart rate, blood pressure, and perfusion
## Footnote
This includes monitoring skin color, capillary refill, and level of consciousness.
116
What is the significance of a non-contrast CT scan in stroke diagnosis?
It determines the way to diagnose a stroke and what type of stroke it is
## Footnote
Types include thrombosis, embolism, hemorrhage, and cerebral edema.
117
What imaging technique is used to assess tissue perfusion in the brain?
MRI/MRA
## Footnote
These scans are used to look at brain tissue and its perfusion.
118
What does EEG stand for and what is its purpose in stroke diagnosis?
Electroencephalogram; it looks for seizures to rule out stroke
## Footnote
EEG helps differentiate between stroke and seizure activity.
119
What do the acronyms PT, PTT, and INR stand for in lab tests?
Prothrombin Time, Partial Thromboplastin Time, International Normalized Ratio
## Footnote
These tests assess how quickly blood clots and are crucial for monitoring anticoagulants.
120
What do H&H refer to in a complete blood count (CBC)?
Hemoglobin and hematocrit
## Footnote
H&H measures red blood cells and their hemoglobin content.
121
Fill in the blank: The ABCs help nurses quickly identify and address the most ______ problems first.
critical
## Footnote
The ABCs provide a structured approach to initial patient assessment.
122
