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intro to geriatric nursing > CVA intro to gero > Flashcards

CVA intro to gero Flashcards

1
Q

What does CVA stand for?

A

Cerebral Vascular Accident (stroke)

CVA is commonly referred to as a stroke.

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2
Q

What are the two main types of stroke?

A
  • Ischemic
  • Hemorrhagic
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3
Q

What is the primary cause of ischemic stroke?

A

Thrombotic Plaque (blood clott)

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4
Q

What causes an embolic stroke?

A

Atrial Fibrillation (blood clott somewhere else in the body &travels to brain)

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5
Q

What is a hemorrhagic stroke often caused by?

A
  • Hypertension
  • Aneurysm
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6
Q

What does TIA stand for?

A

-Transient Ischemic Attack
(mimics a stroke with the symptoms but usually resolves within some time)
-may cause a stroke later on in life

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7
Q

What defines a TIA?

A

Transient loss of blood flow to brain resulting in temporary neurologic dysfunction

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8
Q

What are common risk factors for stroke?

A
  • Hypertension
  • Smoking
  • Dyslipidemia
  • Diabetes
  • Weight
  • Exercise
  • Alcohol use
  • A-Fib
  • CAD
  • Ethnicity
  • Atherosclerosis stenosis
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9
Q

What does the acronym B.E.F.A.S.T. stand for in stroke recognition?

A
  • Balance
  • Eyes (loss of vision?)
  • Face (does the face look uneven?)
  • Arms (is one arm hanging limp?)
  • Speech (trouble speaking?)
  • Time (time is of the essence)
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10
Q

What diagnostic studies are performed for patients with a stroke?

A
  • CT Scan (non contrast)
  • MRI/MRA
  • Brain Scan / Angiography
  • EEG (to rule out seizers)
  • Labs: Clotting factors (PT, PTT, INR)
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11
Q

What is the purpose of the NIH Stroke Scale?

A

To assess the severity of a stroke
(high score=poor)

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12
Q

What is the GCS?

A

Glasgow Coma scale Assessment
(quick stroke assessment)
15= best
7=coma

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13
Q

What is Decussation?

A

is where motor fibers from the brain cross over in the medulla (part of the brainstem), so the left side of your brain controls the muscles on the right side of your body.

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14
Q

What are the clinical manifestations of a right hemisphere stroke?

A

(Harder to recover)
* Left-sided deficits
* Visual/spatial sense deficits
* Poor judgment /impulsiveness
* Denial of deficits
*neglect syndrome
*Disorientation

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15
Q

What are the clinical manifestations of a left hemisphere stroke?

A

(Safer Rehab)
* Right-sided deficits
* Language deficits (Aphasia)
* Agraphia (inability to write)
* Alexia (inability to read)
* Acalculia (inability to calculate)
*depressed, cautious, anxious

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16
Q

What is Homonymous Hemianopsia?

A

-happens in left posterior cerebral artery stroke
-causes vision cuts
-Right CVA=left vision cuts
-Left CVA=right vision cuts

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17
Q

What is the treatment window for administering tPA in ischemic stroke?

A

3 to 4.5 hours from the onset of stroke symptoms

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18
Q

What is the goal of treatment in ischemic stroke?

A

Re-perfuse the brain tissue

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19
Q

What are some nursing diagnoses for stroke patients?

A
  • Ineffective Tissue Perfusion: Cerebral
  • Risk for aspiration / Impaired Swallowing
  • Altered thought processes
  • Disturbed sensory perception
  • Impaired physical mobility
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20
Q

What does oval eye shape mean?

A

increased ICP (intercranial pressure)

21
Q

What does fixed and dilated pupils mean?

A

severe damage to brain

22
Q

What is one of the main goals in the acute phase of stroke management?

A

Maintain Airway – SaO2 > 93%

23
Q

What interventions are crucial during the rehabilitation phase of stroke care?

A
  • Dysphagia precautions
  • Swallow evaluation by Speech Therapist
  • VTE prophylaxis
24
Q

What is the significance of the Joint Commission’s Core Measure Set for Stroke?

A

To ensure quality care for stroke patients through standardized measures

25
What are the signs of increased intracranial pressure (ICP)?
* Headache * Nausea / Vomiting * Confusion * Fixed pupils
26
What are some signs of increased ICP?
*Headache *Nausea *increased BP *Confusion *Seizures *Loss of consciousness
27
What is PNUMBRA?
Part of the brain that is still salvageable after a stroke but is considered "at risk"
28
What are some goals when helping ISCHEMIC strokes?
*Re-perfuse the brain *Bust the clot *Use tPA within 3-4.5 hours *Keep BP somewhat high (140-150)
29
What are some goals when dealing with a HEMORRHAGIC stroke?
*stop bleeding/plug the leak *Watch for increased ICP *Keep blood pressure moderately low (<140/90) *check clotting times
30
What are the two different ways to treat a ISCHEMIC stroke (clot-buster)?
-t-PA through IV -Thrombolysis-Urokinase (done in cathlab)
31
Fill in the blank: A stroke is characterized by the loss of brain function due to loss or disruption of _______ to part of the brain.
blood supply
32
True or False: A left CVA typically results in right-sided deficits.
True
33
What does NPO stand for in patient care?
Nothing by mouth ## Footnote This is a common medical abbreviation indicating that a patient should not consume food or liquids.
34
What position should the patient be in during the swallow screen?
90 degrees sitting up ## Footnote This position helps facilitate swallowing and reduces the risk of aspiration.
35
What are the signs that indicate a successful swallow during the swallow screen?
No coughing, choking, altered voice tone, gurgling, dribbling, watery eyes ## Footnote These signs suggest that the patient is swallowing safely.
36
What should be done if the patient fails the swallow screen?
Keep NPO and have a Swallow Evaluation by Speech Therapist ## Footnote A speech therapist can provide a detailed assessment of swallowing abilities.
37
What is essential VTE prophylaxis for patients with a stroke?
Pneumatic compression stockings/boots or TED’s ## Footnote These devices help prevent venous thromboembolism in immobile patients.
38
What is the best form of ankle movement recommended for stroke patients?
AROM (Active Range of Motion) of ankles ## Footnote AROM helps maintain joint mobility and circulation.
39
What is included in the bowel and bladder care for stroke patients?
Laxative regimen and assisting to commode/schedule ## Footnote Regular bowel and bladder routines help prevent complications.
40
What are the components of skin and mouth care for stroke patients?
Frequent turning and cleaning the mouth before eating ## Footnote These practices help maintain hygiene and prevent skin breakdown.
41
What should be assessed in the communication care of stroke patients?
Deficits in communication ## Footnote Collaboration with Speech Therapy is crucial for effective communication.
42
What strategies should be used when communicating with stroke patients?
Be patient, speak slowly, clearly, and use brief simple instructions ## Footnote Using a communication board can also facilitate understanding.
43
What emotional care should be provided to stroke patients?
Consistent schedule, support from OT, PT, ST, and involving family ## Footnote Emotional support is vital for recovery and adjustment.
44
What specific support is needed for patients with left CVA?
Support and encouragement ## Footnote Left CVA patients may experience different emotional needs compared to right CVA patients.
45
What specific support is needed for patients with right CVA?
Protection and prevention ## Footnote Right CVA patients may require different approaches due to their symptoms.
46
What are the key components of movement care for stroke patients?
ROM exercises, positioning, transfers, assist and teach ADL’s ## Footnote Promoting independent function is a major goal in rehabilitation.
47
What body mechanics should be followed for stroke patients?
Lead with the unaffected side ## Footnote This helps maintain balance and safety during movement.
48
What is the recommended use of a cane for stroke patients?
Use on the unaffected side ## Footnote This provides better support and stability.
49
Fill in the blank: The goal of exercise for stroke patients is to maximize _______.
Self-Care Abilities ## Footnote Encouraging independence in daily activities is essential.

intro to geriatric nursing (2 decks)

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