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Adult care 2 > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

Ischemic stroke patho

A

Disruption in blood supply that lasts more than 24 hours
Two types- thrombotic and embolitic

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2
Q

Thrombotic stroke-ischemic stroke

A

Due to atherosclerosis
S/s occur SLOWLY and develop over time; often have TIA before stroke
-slight headache
-speech deficits
-visual disturbances
-confusion

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3
Q

why may thrombotic s/s occur slowly over time?

A

My have collateral circulation

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4
Q

Embolitic stroke-ischemic

A

Embolus usually from the heart (A-fib)
Clot breaks off and travels to smaller vessels
SUDDEN onset
-facial droop
-slurred speech
-paralysis
-expressive aphasia
More likely to die as clot travels producing more s/s

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5
Q

Hemorrhagic stroke Patho

A

Occurs during activity due to BP and increased pressure on the vessels
Causes: aneurysm, AV malformation
S/s occur quickly:
-headache
-lethargy
-stupor
-coma
-seizures

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6
Q

What is the most common cause of hemorrhagic strokes?

A

AV malformation

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6
Q

AV malformation

A

Arteries shunt directly into veins instead of capillaries

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7
Q

What are the two causes of hemorrhagic strokes?

A

Aneurysm ruptures and AV malformation

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8
Q

TIA patho

A

Transient decrease in blood flow to the brain “halfway to CVA”. Transient focal deficits lasts no longer than 24 hrs
Evaluated with carotid ultrasound and EKG
-drooping, slurred speech, vision changes

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9
Q

Ischemic vs hemorrhagic vs TIA

A

Ischemic=lack/low blood flow to brain, s/s slowly and develop over time or sudden depending on type (thrombotic vs embolitic)
Hemorrhagic= structural or pathological causes
S/s quickly
TIA= warning sign, s/s no longer than 24 hrs

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10
Q

Ischemic stoke assessment findings

A
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11
Q

Hemorrhagic stroke assessment findings

A

S/s occur quickly
Doesn’t look like FAST
-collapse, high BP, increased ICP, decreased LOC, s/s bleeding:enlarged neck, deviated trachea, respiratory distress, dysphagia

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12
Q

TIA assessment findings

A
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13
Q

Ischemic stroke management

A

restore the blood flow-> t-PA
Monitor LOC
Monitor RR and depth
Maintain airway

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14
Q

Hemorrhagic stroke management

A

Too much blood- stop the bleeding!
-control HTN
-complete bed rest HOB elevated, quiet dark room, no stimuli, no caffeine, no hot/cold fluids
-sedate PRN
-NO restraints
-monitor for severe headache, N/V, dec LOC

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15
Q

TIA management

A
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16
Q

Safety concerns w management post CVA

A
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17
Q

Physical limitations for post CVA management and safety concerns

A
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18
Q

Psychosocial concerns post CVA and management safety concerns

A
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19
Q

Early recognition of s/s stroke

A

First thing- what time did s/s start? (4 hr time frame)
-sudden weakness/numbness (face, arm, leg unilateral)
-sudden confusion
-sudden trouble walking
-dizziness or loss of balance/coordination
-sudden severe headaches with no known cause

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20
Q

F.A.S.T assessment

A

Facial drooping - “smile”
Arm weakness/drift-close eyes and extend both arms palms up for 10 sec… drift?
Speech difficulty/slurred-“you cant teach an old dog new tricks”
Time to call 911- 4 hr window for t-PA

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21
Q

Actions to take when recognizing a stroke

A

Call 911 immediately and have EMS call stroke code to clear CT machine; note the time s/s started

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22
Q

Eligibility criteria for t-PA adminstration (Tissue plasminogen activator)

A

Contraindications: other thinners, pregnant, any bleeding, bleeding disorder, recent surgery (neuro/brain.. but all), AV malformation, uncontrolled BP, within 3-4 hour window form onset of s/s, assessed with NIHSS

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23
Q

t-PA

A
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24
Q

Stroke rehabilitation focuses

A

Dysphagia, dysphasia, hemianopsia, unilateral neglect prevention

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25
Q

Dysphagia assessment

A
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26
Q

Dysphagia rehabilitation strategies used

A
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27
Q

Complications of dysphagia

A
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28
Q

Dysphasia

A
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29
Q

Hemianopsia

A
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30
Q

Unilateral neglect

A
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31
Q

What testing identifies the disease?

A
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32
Q

Preop management for carotid disease

A
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33
Q

Post-op management for carotid disease

A
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34
Q

Medications for carotid disease

A
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35
Q

Surgical interventions for carotid disease

A
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36
Q

Pt education for

A
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37
Q

HF nursing interventions

A
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38
Q

HF teaching strategies

A
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39
Q

Diet considerations and fluid restrictions for HF pts

A
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40
Q

Left sided HF

A
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41
Q

Right sided HF

A
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42
Q

How right sided HF affects QOL, ADL, IADL

A
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43
Q

How left sided HG affects QOL, ADL, IADL

A
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44
Q

Weight-HF

A
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45
Q

Discharge (dry) weight HF-why is it important?

A
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46
Q

HF weights-when

A
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47
Q

HF weights-How

A
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48
Q

HF exacerbations

A
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49
Q

HF exacerbations causes

A
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50
Q

What is required for HF exacerbations management?

A
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51
Q

Atrial fibrillation patho

A
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52
Q

Physical assessment findings for Atrial fibrillation

A
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53
Q

Stable findings for A fib

A
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54
Q

Unstable findings for A fib

A
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55
Q

Abnormal EKG presentation for A fib

A
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56
Q

What is the EKG missing for an A fib pt?

A
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57
Q

Cardioversion

A
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58
Q

Stable cardioversion

A
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59
Q

Unstable cardioversion

A
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60
Q

Cardioversion aftercare

A
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61
Q

A fib treatments

A

Cardioversion and ablation

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62
Q

After care by nurse for ablation pt

A
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63
Q

Ablation

A
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64
Q

Oral medications for management for ablation pt

A
65
Q

DVT

A
66
Q

Deep vein thrombosis patho

A
67
Q

DVT physical assessment findings

A
68
Q

DVT labs

A
69
Q

D-Dimer

A
70
Q

Nursing care for DVT

A
71
Q

Medications for management of DVT

A
72
Q

Peripheral vascular disease- arterial physical assessment findings

A
73
Q

Peripheral vascular disease- venous physical assessment findings

A
74
Q

Nursing care of arterial disease

A
75
Q

Nursing care of venous disease

A
76
Q

Differences between arterial and venous peripheral vascular disease

A
77
Q

Medications used for management of arterial PVD

A
78
Q

Medications used for management of venous PVD

A
79
Q

Intermittent claudication-PVD

A
80
Q

S/s intermittent claudicaiton

A
81
Q

Tx for intermittent claudication

A
82
Q

Surgical revascularization indications

A
83
Q

Surgical revascularization

A
84
Q

Surgical revascularization client education pre-op

A
85
Q

Surgical revascularization client education post-op

A
86
Q

Surgical revascularization nursing interventions pre-op

A
87
Q

Surgical revascularization nursing interventions post-op

A
88
Q

Antihypertensive

A

ACE, ARB, Beta blockers

89
Q

Diuretics

A

Aldosterone antagonists, loop diuretics

90
Q

Anticoagulants (old and new)

A

Platelet aggregation inhibitors, NSAIDS, low molecular weight heparin, activated factor Xa inhibitor, and Vitamin K inhibitors

91
Q

ACE examples

A

Captopril, enalapril
-pril

92
Q

ARB examples

A

Telmisartan
-sartan

93
Q

Beta blocker example

A

Metoprolol
-olol

94
Q

Aldosterone antagonists example

A

Spirolactone

95
Q

Loop diuretic example

A

Furosemide

96
Q

Platelet aggregation inhibitors example

A

Clopidogrel

97
Q

NSAID example

A

Aspirin

98
Q

Low molecular weight heparin example

A

Enoxaparin

99
Q

Activated factor Xa inhibitor example

A

Fondaparinux/ rivaroxaban

100
Q

Vitamin K inhibitor example

A

Warfarin

101
Q

Antiarrythmics

A

Calcium channel blockers, cardiac glycosides

102
Q

Calcium channel blocker example

A

Diltiazem, verapamil
-dipine, -amil, -azem

103
Q

Cardiac glycoside example

A

Digoxin

104
Q

Statins

A
105
Q

Pt education for ACE inhibitors

A
106
Q

Pt education for ARBs

A
107
Q

Pt education for Beta blockers

A
108
Q

Safety issues with ACEs

A
109
Q

Safety issues with ARBs

A
110
Q

Safety issues with beta blockers

A
111
Q

Safety issues for aldosterone antagonists

A
112
Q

Pt eduction for aldosterone antagonists

A
113
Q

Pt education for loop diuretics

A
114
Q

Safety issues with loop diuretics

A
115
Q

Pt education for platelet aggregation inhibitors

A
116
Q

Pt education for NSAIDs

A
117
Q

Pt education for LWMH

A
118
Q

Pt education for activated factor Xa inhibitor

A
119
Q

Safety issues for activated factor Xa inhibitor

A
120
Q

Pt education for vitamin K inhibitors

A
121
Q

Safety issues for platelet aggregation inhibitors

A
122
Q

Safety issues for NSAIDs

A
123
Q

Safety issues for LWMH

A
124
Q

Safety issues for vitamin K inhibitors

A
125
Q

Pt education for CCBs

A
126
Q

Pt education for Cardiac glycosides

A
127
Q

Pt education for Statins

A
128
Q

Safety issues for CCBs

A
129
Q

Safety issues for Cardiac glycosides

A
130
Q

Safety issues for Statins

A
131
Q

Key safety issues for CVA

A
132
Q

Key safety issues for carotid disease

A
133
Q

Key safety issues for PVD

A
134
Q

Key safety issues for HF

A
135
Q

Key safety issues for DVT

A
136
Q

Key safety issues for atrial fibrillation

A
137
Q

What needs to be taught to pts regarding CVAs?

A
138
Q

What needs to be taught to pts regarding Carotid disease

A
139
Q

What needs to be taught to pts regarding HF

A
140
Q

What needs to be taught to pts regarding Atrial fibrillation

A
141
Q

What needs to be taught to pts regarding DVT

A
142
Q

What needs to be taught to pts regarding PVD

A
143
Q

What needs to be taught to pts regarding Antihypertensives

A
144
Q

What needs to be taught to pts regarding Diuretics

A
145
Q

What needs to be taught to pts regarding Anticoagulants

A
146
Q

What needs to be taught to pts regarding Antiarrythmics

A
147
Q

What needs to be taught to pts regarding Statins

A
148
Q

CVA diet

A
149
Q

Carotid disease diet

A
150
Q

HF diet

A
151
Q

Atrial fibrillation diet/lifestyle modifications

A
152
Q

DVT diet/lifestlye modifications

A
153
Q

PVD diet/ lifestyle modifications

A
154
Q

What to avoid diet wise with ACEs

A
155
Q

What to avoid diet wise with ARBs

A
156
Q

What to avoid diet wise with Diuretics

A
157
Q

What to avoid diet wise with Anticoagulants

A
158
Q

What to avoid diet wise with Antiarrythmics

A
159
Q

What to avoid diet wise with Statins

A

Adult care 2 (2 decks)

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