GF5: Neuro Strokes and CVAs 2 Flashcards
Pts w/ hemorrhagic stroke are to be given NO medications of what type? Name some.
Blood thinners
NO:
- Aspirin/clopidogrel
- Heparin/enoxaparin
- Warfarin
- Thrombolytics
What is the priority action for a pt w/ suspected stroke?
- Maintain patent airway
- Stat CT scan
- Neuro assessment
- Give tPA
Left sided stroke results in _____ and _____ issues, whereas right sided stroke results in _____ and _____ issues.
Left = language and logic
Right = Reckless and creative
General s/s of left sided stroke?
- Dysphasia
- Reading/writing problems
- Right sided hemiparesis
- Right side neglect
General s/s of right sided stroke?
- Lack of impulse control
- Behavioral changes
- Left sided hemiparesis
- Left side neglect
What are typical behavior characteristics of patients with right sided stroke?
Impatient
Quick to anger
What are typical behavior characteristics of patients with left sided stroke?
Slower to comprehend
Quieter
Strokes can cause visual and spatial deficits. Name a few.
- Monocular vision loss: one eye works
- Bitemporal hemianopia: tunnel vision
- Contralateral homonymous hemianopia: Can only see one side (L or R) from both eyes
Left homonymous hemianopia is a result of a stroke located where?
Right side of the brain
PTs w/ hemianopsia are @risk of self neglect. What is our PT education re: getting dressed?
Dress the weaker side first
What is our safety education for PTs w/ hemianopsia?
- Scan surroundings
- Turn head to affected side
- Teach family to approach PT from unaffected side
True or False
A stroke patient w/ dysphagia is permitted a regular diet.
False, must be pureed until swallow function is restored
Why do we obtain vital signs and assist with morning care in one visit for a stroke patient?
Prevent sensory overload (keep environment as undisturbed as possible)
Prevent activities that would increase ICP or hemorrhage
How long does a stroke pt need to be NPO?
Until a swallow screen is performed
What are our nursing actions regarding feeding with a stroke pt?
- Teach “flex neck” while swallowing
- AVOID sedation meds before meals
- HOB up
- For dysphagia pts
- Pureed diet, not regular
- Add thickening agent to fluids
What is important to keep in mind with transferring a stroke pt from bed to chair?
Use a transfer belt
Always transfer w/ their stronger side first
How do we approach ADLs with stroke pts?
Do not complete tasks for client
Allow them to learn
True or False
If a stroke patient is having a hard time understanding what you are saying, be sure to speak in a loud clear voice.
False, the problem is with receptive aphasia, not hearing. Just speak clearly at a normal volume with simple yes or no questions
What is the Braden Score?
An assessment tool used for risk of ulcers for bedridden pts
- Score range of 6-23
- High score = low risk
- Low score = high risk
A stroke pt may have hemiparesis which can make eating difficult. How is this addressed?
- OT/PT will handle it
- They will teach about Bobath tech (special utensils to make eating easier)
- Utensils will be shaped differently with wide handles to make grasping easier
What is akinesia?
Loss of skillful voluntary movement
What is apraxia?
Can move affected body part, but not for specific purposes
What is Dysarthria?
Slurred speech
What is astereognosis?
Inability to recognize objects in hands without being able to see them
