EXAM 2B - STROKE

Question 1

__________ contributes to over 12.7 million strokes annually

Answer 1

Hypertension

Question 2

Non-modifiable contributing factors of stroke

Answer 2

Age. Common in ppl aged 55>
Gender - women
Ethnicity - NZ Maori
Genetics

Question 3

Modifiable contributing factors of stroke

Answer 3

Hypertension. High cholestol. Diabetes. Smoking. Obesity

Question 4

Two types of stroke are

Answer 4

Ischaemic stroke & Haemorrhagic stroke

Question 5

Ischaemic stroke accounts for 85% of strokes. What are the two sub classifications of this?

Answer 5

Cerebral embolism>a blood clot formed elsewhere that travels to the brain. Unable to pass it will block the artery, interrupting blood flow causing tissue ischaemia

Cerebral thrombosis>narrowing of cerebral arteries causing plaque build-up. Clot then forms on the plaque, blocking the blood flow to brain

Question 6

Haemorrhagic stroke. What happens in this type of stroke

Answer 6

A burst blood vessel will cause blood to leak into brain tissue and surrounding structures, causing a rise in intracranial pressure and damage to brain tissue

Question 7

Transient ischaemic attack (TIA) what is this

Answer 7

A temporary focal loss of neurological function caused by ischaemia, resolves within 1-2 hours. Results from < blood flow to brain or partial or complete occlusion of artery. HIGH RISK FOR STROKE

Question 8

Cerebral aneurysm’s occur where?

Answer 8

Circle of Willis

Question 9

Brainstem strokes may lead to

Answer 9

Coma
Breathing problems, spontaneous changes in blood pressure and heart rate
Nausea and vomiting

Question 10

Cerebellar strokes

Answer 10

Ataxia[drunk like, slurred speech], dysarthria, incoordination, nystagmus[eyes making uncontrolled movement]

Question 11

Differences between RBI[right brain injury/stroke] to LBI[left brain injury/stroke]

Answer 11

RBI
Paralysed left side

Special perceptual deficits

QUICK, impulsive behavioural style

Memory deficits

LBI
Paralysed right side

Speech and language deficits

SLOW, cautious behavioural style

Memory deficits

Question 12

You’re throwing an education session on signs and symptoms to watch for if a person is about to have a stroke. What do you mention

Answer 12

FAST ACRONYM
Face –has it drooped
Arm – is one arm weaker
Speech – is it slurred, jumbled?
Time – act fast

Signs and symptoms include
Paralysis/weakness in the face, arms &/or legs.
Confusion. 
Personality changes.
Sudden change in eyesight. 
Decreased motor skills.
Severe headaches

Question 13

Nursing interventions – acute phase

Answer 13

Maintain head of bed 30◦
to facilitate jugular venous drainage and help reduce intracranial pressure

Maintain systolic blood pressure within prescribed parameters (often < 180mmHg)
to reduce the potential for further bleeding or ischaemic changes

Continuous neurological observations
to help identify deterioration to initiate timely intervention and treatment

Ensure patient is kept NBM until swallow is assessed by Speech and Language Therapist
to prevent aspiration of oral fluid and food

Administer prescribed aspirin orally or enterally
to impede clotting and prevent further ischaemia

Question 14

Nursing management – rehabilitation.

Goals are that the patient will:

Answer 14

Attain maximum physical functioning

Attain maximum self-care abilities and skills

Maximise communication abilities

Maintain adequate nutrition

Avoid complications

Maintain effective personal and family coping

Make positive lifestyle changes (health promotion)