Hear 5b Stroke

Question 1

Stroke

Answer 1

Is commonly associated with other diseases. Where cerebrovascular disease was listed as the underlying cause of death, common associated causes of death included hypertensive disease

Question 2

Types of stroke

Answer 2

Ischaemic

Haemorrhagic

Question 3

Ishaemic and types

Answer 3

Majority of strokes

Thrombotic, lacunar and embolic

Question 4

Haemorrhagic

Types

Answer 4

Accounts 15-20% of all strokes and around 50% of all mortality related strokes
Intracerebral and subarachnoid

Question 5

Risk factors of stroke

Answer 5

Non-modifiable

Modifiable

Question 6

Non-modifiable

Answer 6

Age
Gender
Ethnicity
Family history

Question 7

Modifiable

Answer 7

Hypertension 
Heart disease
Obesity 
Diabetes mellitus 
Smoking
Excessive alcohol consumption 
Sleep apnoea
Lack of physical exercise

Question 8

Right brain damage

Answer 8

Paralysed left side : hemiplegia
Left side neglect
Tends to deny or minimise problems
Rapid performance, short attention span
Impaired judgement 
Impaired time concepts
Spatial - perceptual deficits

Question 9

Left-brain damage

Answer 9

Stroke on left side
Paralysed right side: hemiplegia
Impaired right/left discrimination
Slow performance 
Aware deficit; depression 
Impaired comprehension related to language, mathematics

Question 10

Acute care for stroke

Goals

Answer 10

Preserving life
Preventing further brain damage
Reducing disability
Time of onset of symptoms is critical information

Question 11

Acute care for stroke begins with managing

Answer 11

Airway

Breathing circulation

Question 12

Responsibilities of the jurse jn the care of the patient

Answer 12

Rapid assessment and facilitation of diagnostic and early intervention processes
Ensuring timely screening or assessment of the patients
Monitoring and responding to routine aspects of acute or subacute care
Providing care considerations of their deficits and in collaboration with mdt
Identifying and managing complications
Reinforcing secondary prevention measures
Coordinating discharge and follow-p services

Question 13

Initial stroke care

Investigations

Answer 13

Rapid assessment in the ed
Brain imaging
Vascular imaging
Cardiac investigations

Question 14

Initial stroke care

Medical and surgical management

Answer 14

Admit to stroke unit
Assess for rehabilitation 
Palliative care as needed
Reperfusion therapy 
Acute bp lowering
Oxygen therapy 
Glycaemic therapy- monitor bgl for 72 hours
Pyrexia management 
Neurountervention - endovascular thrombectomy

Question 15

Surgical therapy for hemorrhagic stroke

Answer 15

Surgical interventions used ti treat haemorrhagic stroke include
Resection
Clipping an aneurysm
Evacuation of hematomas

Procedure is chosen based kn cause of the stroke