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N232 > Module 7 Part 1: CVA > Flashcards

Module 7 Part 1: CVA Flashcards

1
Q

what is a CVA?

A

occurs when blood flow to the brain is interrupted by a blocked or busted blood vessels

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2
Q

what is a CVA d/t blocked vessels called?

A

ischemic

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3
Q

what percentage of strokes are ischemic?

A

80%

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4
Q

what is a CVA d/t a burst vessel?

A

hemmorhagic

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5
Q

what percentage of strokes are hemmhoragic?

A

20%

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6
Q

what determines the extent of brain function and thus the severity of the stroke?

A

the duration, severity, and location of the cerebral ischemia

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7
Q

what are the non-modifiable risk factors of a CVA?

A

male, age, race

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8
Q

what are modifiable risk factors of a CVA?

A

HTN, Afib, hyperlipidemia, obesity, smoking, diabetes, periodontal disease

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9
Q

if the stroke is on the left side of the brain what side of the body will be affected?

A

the right!

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10
Q

what are causes of ischemic strokes?

A
  • large artery thrombotic
  • small penetrating artery thrombotic
  • cardiogenic embolic (A fib pts)
  • crytogenic (no known cause)
  • cocaine use
  • migraines
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11
Q

what is the number one cause of hemorrhagic strokes? why?

A

HTN (causes aneurysm to burst)

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12
Q

what is a TIA?

A
  • transient ischemic attacks

- like angina

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13
Q

do TIAs cause permanent damage?

A

no

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14
Q

how does a TIA present?

A

as a stroke, but then completely reverses

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15
Q

what is the acronym for signs of a stroke?

A

FAST

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16
Q

what motor function is lost in a CVA?

A
  • hemiplegia
  • hemiparesis
  • ataxia
  • dysphagia
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17
Q

what is hemiplegia?

A

paralysis of one side of body

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18
Q

what is hemiparesis?

A

weakness of face, arm or leg d/t lesion on other side of brain

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19
Q

what is ataxia?

A

unsteady gait

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20
Q

what is dysphagia?

A

difficulty swallowing

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21
Q

what are the communication losses present in a CVA?

A
  • dysarthria
  • dysphasia
  • aphasia
  • apraxia
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22
Q

what is dysarthria?

A

difficulty speaking caused my paralysis of muscles with speech

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23
Q

what is dysphagia?

A

difficulty/loss of speech

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24
Q

what is aphasia?

A

can be mixed

25
Q

what is apraxia?

A

inability to preform previously learned skills

26
Q

what are the perceptual changes in a patient with a CVA?

A
  • visual perceptual dysfunctions d/t disturbances of the primary sensory pathways between the eye and visual cortex
  • homonymous hemianopsia (loss of half of field of vision)
27
Q

is homonymous hemianopsia permanent?

A

it can be, not always

28
Q

what are sensory losses associated with CVA?

A
  • touch impairment

- difficulty interpreting stimuli

29
Q

what are cognitive impairments of CVAs?

A
  • frontal lobe damage
  • limited attention span
  • comprehension difficulty
  • forgetfulness
  • apathy
30
Q

what does frontal lobe damage cause?

A

loss in learning capacity, memory, and other higher intellectual functions

31
Q

what are the emotional deficits with CVAs?

A
  • loss of social filters (eg. clothes off in public)
  • loss of self-control
  • emotional lability
  • withdrawal
  • fear, hostility, anger
  • feelings of isolation
32
Q

what do CT scans show with CVAs?

A

whether it is hemorrhagic or ischemic

33
Q

what is the CT angiogram? and does it show?

A

punctures the patient’s artery and feed the catheter and inject dye to see what vessel is occluded

34
Q

what is a carotid ultrasound?

A

on the carotid artery to see if sufficient blood flow

35
Q

would you use an MRI or CT first? why?

A

TIME IS TISSUE!

- the CT is faster

36
Q

when do you give rtPA (thrombolytic)?

A

within 4.5 hours

1.5 hours LONGER than what we learned in patho… how annoying

37
Q

what patients can you give tPA to?

A
  • normal CT scan
  • BP <180/100
  • no bleeding tendancy
38
Q

what is the does of tPA you can give?

A
  1. 9mg/kg (max 90mg)

- 10% bolus, rest 60 mins by infusion

39
Q

what is the risk of giving a tPA?

A

intracranial haemorrhage (6% of patients)

40
Q

what are other pharm interventions for CVA?

A
  • thrombolytic
  • antihypertensives
  • anticoagulant
  • platelet inhibiting medications
  • anticonvulsant
41
Q

what are some nursing care for after a TPA?

A
  • rest
  • oxygen
  • IV access
  • watch for signs of bleeding
  • neurovitals & BP frequently
  • inc. HOB
  • blood glucose monitoring
  • monitor/manage fever
42
Q

do all patients suffer shoulder pain post CVA?

A

no, only 70%

43
Q

what is nursing care for shoulder pain?

A

proper positioning of weak arm/shoulder and support from pillows ESPECIALLY with paralysis

44
Q

how do nurses care for the nutrition of CVA patients?

A
  • dysphagia - difficulty swallowing

- at risk for aspiration pneumonia

45
Q

how to reduce risk of aspiration pneumonia?

A
  • HOB 30 degrees

- feeding tubes

46
Q

what area of the brain is in charge of understanding speech?

A

Brocca’s area

47
Q

what do nurses need to assess with skin?

A

tissue breakdown d/t altered sensation and pressure

- special beds, regular turning and poisitoning

48
Q

how often should you reposition a patient?

A

Q2h

49
Q

nursing care for the bladder post CVA?

A

intermittent catheterization, atonic bladder

50
Q

nursing care for bowels post CVA?

A

constipation d/t dec. mobility - fibre foods, medications

51
Q

what are the S&S of an ischemic stroke?

A
  • numbness
  • weakness of face, arm or leg
  • especially one side of body
52
Q

how long is the usual functional recovery from an ischemic stroke?

A

usually plateaus at 6 months

53
Q

what are the causes of hemorrhagic strokes?

A
  • intercerebral hem
  • subarachnoid hem
  • cerebral aneurysm
  • arteriovenous malformation
54
Q

what are the S&S of a hemorrhagic stroke?

A
  • “exploding headache”

- dec. LOC

55
Q

how long is the usual functional recovery for hemorrhagic strokes?

A

slower usually, plateaus at about 18 months

56
Q

what do clinical manifestations depend on?

A
  • the location of the lesion
  • the size of the area of inadequate perfusion
  • the amount of collateral blood flow
57
Q

how much does the brain age each hour without treatment following a CVA?

A

3.6 years

58
Q

what are the medications called that protect the brain from secondary injury? wha do they do?

A

neuroprotectants

- help improve cellular environment

59
Q

how long does a TIA usually last?

A

less than 1 hour

N232 (9 decks)

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