CVA or Stroke (Hon)

Question 1

About how many stroke survivors will have another?

Answer 1

1/4th (25%)

Question 2

What are the two subtypes of stroke?

Answer 2

Ischemic (80%)
Hemorrhagic (20%)

Question 3

What are some of the risk factors of stroke?

Answer 3

increasing age
previous stroke (25% will have another)
atherosclerosis
cardiac disorders
drug abuse
oral contraceptive (excess estrogen)

Question 4

Symptoms of a left hemisphere stroke?

Answer 4

Aphasia (speech), RIGHT sided sensory symptoms, RIGHT sided motor symptoms and RIGHT visual field cut

Question 5

Symptoms of right hemisphere stroke?

Answer 5

LEFT hemineglect, LEFT sided sensory symptoms, LEFT sided motor symptoms, LEFT visual field cut

Question 6

Symptoms of cerebellar damage due to a stroke?

Answer 6

Ipsilateral ataxia, vertigo, nystagmus

Question 7

Symptoms of brainstem damage due to a stroke?

Answer 7

CN finding with c/l hemisensory or hemimotor symptoms, vertigo

Question 8

What are the 3 ways the brain responds to injury?

Answer 8

Swell
Bleed
Seize

Question 9

How should you treat acute HTN in a stroke patient?

Answer 9

Acute HTN is common in acute ischemic stroke and should NOT be treated; can further the ischemia of the brain

Question 10

When treating a stroke patient what should NOT be included in the IV line?

Answer 10

IVF’s should NOT include glucose as hyperglycemia is associated with worse neurological outcomes

Question 11

Why should glucose NOT be included in the IVF when treating stroke patients?

Answer 11

associated with worse neurological outcomes

Question 12

If a tPA is a consideration for treatment for a stroke patient, how many IV access sites will be needed?

Answer 12

two IV access sites will be needed to eliminate venipuncture after infusion

Question 13

What is the lab workup for a stroke patient?

Answer 13

CBC w diff
PT/PTT
full chemistry panel and finger stick glucose
UA
CXR

Question 14

Why is a NIH stroke scale used?

Answer 14

If considering tPA for treatment is used to predict hemorrhagic conversion; score ranges from 0 (normal) to 42 (coma)

Question 15

A NIH Score <10

Answer 15

there is a 2-3% risk of hemorrhage

Question 16

A NIH Score of >20

Answer 16

there is a 17% risk of hemorrhage

Question 17

How long does it typically take for an ischemic stroke to show up on a CT scan?

Answer 17

72 hours (3 days)

Question 18

Which anti-coagulate is indicated in a stroke patient with a-fib?

Answer 18

warfarin

Question 19

Signs and symptoms of a stroke?

Answer 19

BE FAST
Balance (loss)
Eyes (blurred vision)

Face (one side is drooping)
Arms (weakness)
Speech (difficulty)
Terrible headache