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NRSG 110: Med Surg 2 > [Exam 4] Chapter 67: Management of Patients with Cerobrovascular Disorders (Page 2009-2013, 2017, 2025-2028) > Flashcards

[Exam 4] Chapter 67: Management of Patients with Cerobrovascular Disorders (Page 2009-2013, 2017, 2025-2028) Flashcards

1
Q

What is a Cerebrovascular Disorder?

A

Functional abnormality of the CNS that occurs when the blood supply is disrupted

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2
Q

What is the primary Cerebrovascular Disorder?

A

Stroke

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3
Q

Cerebrovascular Disorders: What two strokes will we look at?

A

Ischemic (80-85%) and Hemorrhagic (15-20%)

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4
Q

Cerebrovascular Disorder: Whats a nonmodifiable risk factor?

A

Age (older than 55) , male, or African Americans

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5
Q

Cerebrovascular Disorder: What are some modifiable risk factors?

A

Hypertension

CVD

Elevated Cholesterol or Hematocrit

Obesity

Diabetes

Oral Contraceptive Use

Smoking and Drug and Alcohol Abuse

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6
Q

Cerebrovascular Disorder: What happens when blood supply to brain is disrupted?

A

Brain tissues die, and leads to physical impairments due to neuronal death

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7
Q

Cerebrovascular Disorder: What is a stroke known as?

A

“Brain Attack”

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8
Q

Ischemic Stroke: What is this?

A

Obstruction of blood supply usually a thrombus or embolism that causes infarction of brain tissue

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9
Q

What is Hemiplegia?

A

Paralysis on one side of body

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10
Q

What is Hemiparesis?

A

Weakness on one side of body

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11
Q

What is Dysarthria?

A

Difficult or unclear speech that is linguistically normal

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12
Q

What is Aphasia?

A

(Inability to express speech, error in sentence structure or word choice) Expressive aphasia(The word meaning keeps changing, but knows what diet coke is), receptive aphasia. (hears diet coke, but thinks of something else)

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13
Q

What is Hemianopsia?

A

Blindness over half the field of vision

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14
Q

What is a Transient Ischemic Attack (TIA)?

A

Temporary neurologic deficit resulting from a temporary impairment of blood flow

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15
Q

Transient Ischemic Attack (TIA): This does not cause..

A

long term deficit

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16
Q

Transient Ischemic Attack (TIA): Warning sign of

A

an impending stroke

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17
Q

Transient Ischemic Attack (TIA): What needs to be done to prevent CVA?

A

Diagnostic Workup

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18
Q

Transient Ischemic Attack (TIA): Original symptoms look similar to

A

a stroke, but don’t last as long. MRI/CT shows no damage

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19
Q

Cerebrovascular Disorder: Health maintenance measures include

A

a healthy diet, exercise, and the prevention and treatment of periodontal disease

20
Q

TIA: Preventive measures /Medical Management include?

A

Carotid Endarterectomy (Done to remove atheroscletotic plaques blocking cerebral blood flow)

Anticoagulant Therapy - 81 mg ASA

Antiplatelet Therapy : Aspirin, Dipyridamole plus Aspirin, Clopidogrel

“Statins” (decreases cholesterol)

Antihypertensive Meds

21
Q

Ischemic Stroke: Signs of this?

A

Numbness or Weakness of Face (Facial Drooping), Arm, Or Leg

Confusion of Change in Mental Status

Trouble Speaking/Understanding Speech

Difficulty in walking, dizziness, loss of balance

Sudden, severe headache

Perceptual Disturbances

22
Q

Ischemic Stroke: What will you do during the acute phase of the stroke? Ongoing frequent monitoring of all systems including

A

VS and neurologic assessment: LOC, motor symptoms, speech, eye symptoms

23
Q

Ischemic Stroke: Acute Phase, monitor for what potential complications?

A

Musculoskeletal Problems, Swallowing Difficulties, Respiratory Problems, And S&S of increased ICP and Meningeal Irritation

24
Q

Ischemic Stroke: After the stroke is complete, what will you assess?

A

Focus on patient function; self-care ability, coping, and education regarding needs to facilitate rehabilitation

25
Q

Ischemic Stroke: Increased ICP can lead to what symptoms?

A

N/V

Increased BP

Decreased LOC

Decreased Pupil Constriction

Double Vision

Shallow Breathing

Seizures

26
Q

Ischemic Stroke: Assessment, view if the patient is able to perform what?

A

ADLs, swallowing impairments or ability to communicate

27
Q

Cerebrovascular Disorder: What are the Nursing Diagnosis? (13)

A

Impaired Physical Mobility

Acute Pain

Self-Care Deficit

Disturbed Sensory Perception

Impaired Swallowing

Urinary Incoontinence

Disturbed Thought Process

Impaired Verbal Communication

RF Impaired Skin integrity

Interrupted Family Processes

Depression

Ineffective tissue perfusion

Anxiety

28
Q

Cerebrovascular Disorder: What are the goals for this? (13)

A

Improved Mobility

Avoidance of shoulder pain

Self-Care Achievement

Relief of sensory and percecptual deprivation

Prevention of apspiration

Continence

Improved thought process

Achievement of communication

Maintain skin

Restored family function

relief of depression

absence of complications

improved cerebral tissue perfusion

29
Q

Hemorrhagic Stoke: What is this caused by?

A

Bleeding into the brain tissue, ventricles, or subarachnoid space

30
Q

Hemorrhagic Stoke: This could be caused by what?

A

Spontaneous rupture of vessels RT hypertension , subarachnoid hemorrhage caused by ruptured aneurysm , anticoagulants, or aneurysm rupture

31
Q

Hemorrhagic Stoke: What happens to brain metabolism here?

A

Disrupted due to blood exposure. Blood around the brain tissues causes increased pressure compressing arteries reducing blood flow in addition to the lack of blood flow from the bleed

32
Q

Hemorrhagic Stoke: Body vasoconstricts due to

A

blood loss leading to even less blood flow to brain tissue and it becomes ischemic

33
Q

Hemorrhagic Stoke: ICP increases caused by

A

blood in the subarachnoid space

34
Q

Hemorrhagic Stoke: What causes injury to brain tissue?

A

Compression or secondary ischemia from reduced perfusion or vasoconstriction

35
Q

Hemorrhagic Stoke: Signs of this?

A

Similar to ischemic

Early/Sudden Change in LOC

Severe Headache with projectile vomiting thats very forceful

36
Q

Hemorrhagic Stoke: What should you monitor in the patient?

A

Monitor fluid balance and Hgb, Hct, BUN, and Cr

37
Q

Hemorrhagic Stoke: Assessment for someone with this?

A

Neurologic Assessment, use neurologic flow chart

Monitor respiratory and oxygenation

Monitor ICP

Monitor for potential complications

Monitor fluid balance/lab

All changes reported immediately

38
Q

Hemorrhagic Stoke: Where should a patient with intracerebral or subarachnoid hemorrhage be monitored?

A

ICU

39
Q

Hemorrhagic Stoke: Diagnosis for someone with this?

A

Ineffective Tissue Perfusion (Cerebral)

Disturbed Sensory Perception

Anxiety

40
Q

Hemorrhagic Stoke: Goals for this include

A

Improved cerebral tissue perfusion

Relief of sensory and perceptual deprivation

Relief of anxiety

absence of complications

41
Q

Cerebrovascular Disorder: Complications with this?

A

Aspiration

Skin Breakdown

Falls

Musculoskeletal Comps: Contractures, Atrophy

ICP

42
Q

Cerebrovascular Disorder: Prevention of this?

A

Healthy Diet: Low Fat, Low Cholesterol

Exercise

Prevention and Tx of Peridontal Disease

43
Q

Cerebrovascular Disorder: Labs that will be used here?

A

CT, MRI

44
Q

Cerebrovascular Disorder: What interventions will we perform?

A

Aspiration Precautions

OT,PT, ST

Turn Q4h

Up with Assistance

REport changes immeditaly

45
Q

Cerebrovascular Disorder: Education for patient?

A

Prevention

Signs and symptoms of stroke and to recieve immediate care

Teaching new ways to perform ADLs with deficits

NRSG 110: Med Surg 2 (29 decks)

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