CVA Treatment (Exam 2)

Question 1

Treatment of CVA: First Focus

Answer 1

Airway
Breathing
Circulation

Might need to provide supportive measures first

GCS less than 8 = intubate

Question 2

After assessing ABC’s you can then initiate a

Answer 2

Stroke protocol

Question 3

CVA: After checking ABC’s and initiating stroke protocol, what is our next step?

Answer 3

CT Scan without contrast to exclude hemorrhage

Better than MRI in acute stage (MRI takes to long)

Question 4

Treatment for Hemorrhagic Stroke

Answer 4

-Reverse Anticoagulation

-Manage Hypertension

-Manage elevated ICP

Question 5

What drug do we give for ischemic type strokes?

Answer 5

Thrombolytics

Question 6

Fibrinolytics are used to

Answer 6

remove thrombi after they have formed

Question 7

Alteplase: Class

Answer 7

Fibrinolytic

Question 8

Alteplase: MOA

Answer 8

Promotes conversion of plasminogen to plasmin

Question 9

Alteplase: Uses (indication)

Answer 9

Acute MI

PE

Ischemic Stroke

Question 10

What should we monitor when giving fibrinolytics

Answer 10

BP - HR (bleeding)

Arrhythmias

Hypotension

Question 11

What must be done first before administering alteplase?

Answer 11

CT scan to rule out hemorrhage

Health History to Confirm that there is no history of intracranial bleed

Question 12

Alteplase: Adverse Effects

Answer 12

Increased risk of intracranial bleeding

Question 13

Alteplase antidote

Answer 13

Aminocaproic Acid (Amicar)

-anti-thrombolytic

-used to stop bleeding

Question 14

Penumbra Procedure / Mechanical thrombectomy

Answer 14

Procedure that goes in and tries to remove the clot

Thrombectomy

Question 15

Left Brain Residual Effects of CVA

Answer 15

-Logic

-Verbal

-Detail

-Science

-Names

-Math

-Form strategies

-Orders

-Thinking

-Writing

Question 16

Right Brain Residual Effects of CVA

Answer 16

-Pictures

-Stories

-Big Pictures

-Observation

-Shapes

-Music

-Patterns

-Beauty

-Imagination

-Possibilities

Question 17

CVA: Consequence Dysphagia

Answer 17

Swallow study for aspiration before giving anything PO

Barium swallow

Question 18

CVA Consequences: Motor and Function

Answer 18

Patients might neglect or ignore parts of body because they are no longer getting sensory input

Increase risk of falls

Loose function of muscle group

Question 19

CVA: MSK Consequences

Answer 19

Contralateral Side = Flaccidity

Spasticity = Within 6 weeks

Contractures

Question 20

CVA Consequences: Visual Disturbances

Answer 20

Contralateral field blindness

Homonymous hemianopia (right or left side of both visual field loss)

Question 21

CVA Consequences Communction

Answer 21

Aphasia
-difficulty understanding
-difficulty speaking
-difficulty writing
-difficulty reading

Question 22

Aphasia

Answer 22

Some degree of inability to speak or to comprehend

Question 23

Dysphasia

Answer 23

Impairment of speech

Question 24

Dysarthria

Answer 24

Imperfect speech sounds

Question 25

Expressive aphasia

Answer 25

comprehension intact but cannot express Can not express

Question 26

Receptive aphasia

Answer 26

can communicate but cannot comprehend what is being said Can not receive

Question 27

CVA Consequences Memory

Answer 27

Most memory problems are with remembering names, words, objects

Question 28

CVA Consequences Behavioral Problems

Answer 28

Increase in emotional response May underestimate own abilities Slow reaction times Hesitant cautious May be apathetic, confused, disoriented