Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NUR 329 > Neuro/Stroke > Flashcards

Neuro/Stroke Flashcards

0
Q

The brain constitutes ____ of body weight

A

2%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

Def Monroe Kellie hypothesis

A

The Monro-Kellie hypothesis states that the cranial compartment is incompressible, and the volume inside the cranium is a fixed volume. The cranium and its constituents (blood, CSF, and brain tissue) create a state of volume equilibrium, such that any increase in volume of one of the cranial constituents must be compensated by a decrease in volume of another.[5]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

The brain uses _____ of resting CO

A

20%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Lower fx of the brain

A

Hr
Resp
Digestion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Higher fx of the brain

A

Thought
Reason
Abstraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What controls our primal instincts and most basic fxs

A

Hindbrain and midbrain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

The hindbrain consists of …

A

SC
Medulla oblongata
Pons
Cerebellum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

The SC consists of _____ and ______ pathways

A

Ascending

Descending

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What does the medulla oblongata control

A

Autonomic fxs:

  • Resp
  • digestion
  • hr
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What does the Pons control

A
  • consciousness
  • sleep
  • level of arousal
  • autonomic body fxs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What does the cerebellum control

A
  • regulates and coordinates body mvmt
  • posture
  • balance
  • learning mvmt
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does the limbic system control

A

Emotions

Unconscious value judgements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does the limbic system consist of

A
  • amygdala
    -hippocampus
    Hypothalamus
    Thalamus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the amygdala responsible for

A

Processing of memory

Emotional reactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What does the hippocampus do

A

Long term memory

Spatial navigation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What does the hypothalamus control

A

Regulated metab processes/ANS

  • body temp
  • hunger
  • thirst
  • circadian rhythm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What does the thalamus control

A

States of sleep and wakefulness
Arousal
Level of awareness
Consciousness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

The cerebral cortex is divided into ____ ____ and ____ ______

A

Left hemisphere

Right hemisphere

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Ridges on the cerebral cortex is aka

A

Gyri

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Grooves on the cerebral cortex is aka

A

Sulci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Deeper grooves on the cerebrum is aka

A

Fissures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

The cerebral cortex is made of

A 
Frontal lobe
Parietal lobe
Temporal lobe
Occipital lobe
Corpus colossum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the frontal lobe responsible for

A 
Reasoning
Prob solving
Judgement
Impulse control
Higher emotions- empathy, altruism 
Speech- Broca's area
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What does Broca’s area responsible for

A

Speech

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Where is Broca’s area located

A

Frontal lobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the parietal lobe responsible for

A 
Pain
Touch sensation
Cognition- calcs and speed of objects
Mvmt
Orientation
Recognition
Speech
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the temporal lobe responsible for

A

Hearing
Sound sensation
Auditory cortex
Wernickes area- language recognition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Where is wernickes area located

A

Temporal lobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the wernickes area responsible for

A

Language recognition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the corpus colossum

A

Neural bridge that connects the 2 hemispheres

In the center of the brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What do you monitor in elderly patients pits op heart surgery and why

A

Monitor carotid a with duplex bc they easily stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

CSF FYI

A
  • brain and SC
  • contained by the dura lining
  • 125-150 mL
  • clear, colorless, odorless
  • delicate balance must be maintained to regulate ICP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Purpose of the dura lining

A

Cushion the CSF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the blood brain barrier (bbb)

A

Structure that acts to protect the brain from harmful chemicals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What size particles can cross the bbb

A

< 500 Dalton’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What are the most important parts of the Neuro exam and why are they significant

A

LOC
Mentation
Change in either can Be the first clue to Neuro deterioration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Name the different levels of consciousness

A 
Full consciousness 
Lethargy
Obtunded
Stupor 
Coma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Describe lethargy

A

Drowsy but easily woken

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Describe obtruded

A

Patient difficult to arous and needs constant stimulation to follow a command

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Describe stupor

A

Patient arouses with constant and vigorous stimulation- usually pain
Will withdraw from pain but will not follow commands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Describe coma

A

Patient is not aroused with constant or painful stimulation

Only mvmt may be reflexive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Describe the GCS

A
  • a numerical rating of eye,verbal, and Motor responses
  • baseline can be used for comparison
  • 9-15: mild- moderate injury
  • 3-8: severe injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Change in LOC can be indicative of…

A
  • hypoxia
  • hypercarbia: Carbon monoxide
  • hypotension
    Drug related
    Hypothermia
    Prostictal state- post seizure
    Hypoglycemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Pupillary response

A
  • fixed: brisk, sluggish, non reactive

- ETOH/drugs may mask response (Pinpt pupils)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What do fixed and dilated pupils indicate

A

Herniation syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

How do you assess motor strength bilaterally

A

Squeeze hands
Lift limb
Push against resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

How do you check for arm pronation/drift

A

Arms outward
Palms up
Eyes closed
Observe for arm drifting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

How do you assess motor response in an unconscious pt

A

Central stimulation

Peripheral stimulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

How do you test central stimulation

A

Sternal rub

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

How do you test peripheral stimulation

A

Nail bed pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Is testing central or peripheral stimulation better and why

A

Central stimulation creates an overall body response and is more reliable.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Abnormal motor response

A

Posturing

  • flexion
  • extension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What is flexion

A

Decorticate posturing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What is extension

A

Decerebrate posturing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Why is posturing significant

A

Poor prognostic sign

At risk for constant vegetative state

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

List the types of muscle tones

A

Flaccid
Rigid
Spastic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Def flaccid

A

Rag doll appearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

If a pts muscle tone is flaccid, they are at risk for what?

A

Foot drop

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What can you do for a pt with foot drop

A
  • give them a boot

- ask family to bring in sneakers for support

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Describe rigid muscle tone

A

Increasing resistance to PROM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Pts with rigid muscle tone are at an increased risk for what?

A

Contractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Describe spastic muscle tone

A

Rigidity, contracture, spasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Testing sensation allows the HCp observe the pts ability to distinguish bx ….

A

Sensation and lack of sensation

Sharp and dull

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

When assessing gait, what should you observe for

A 
Even and steady?
One limb drag
Shuffling
One or both arms not swing
Posture
Balance
Coordination
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Name the DTRs

A 
Tricep
Bicep
Brachioradialis
Patellar
Achilles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

The plantar reflex is a _______ reflex

A

Superficial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Which reflex is commonly assessed

A

Plantar reflex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Describe babinsky sign

A
  • babies: extension of the big toe is normal
  • > 2 yo: curling of the ties
    Extension of the big toes or fanning is abnormal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Describe the gag reflex

A
  • protective reflex

- yankaur / tongue blade to back of throt should produce gag reflex.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Vital signs and Neuro status

A
  • injury to CN X will demonstrate vital sign changes

- abnormal vital signs are not a reliable indicator of Neuro deterioration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What is cushings triad

A

ICP produces a specific set of changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

When will a cushings triad be seen

A

Late indicators of Herniation syndromes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

List the cushings triad components

A
  • incr syst BP w/ widening pulse pressure
  • bradycardia
  • bradypnea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What is the normal ICP range

A

1-15 mm hg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Def Herniation syndrome

A
  • occurs when cerebral pressure is not exerted evenly

- one portion of the brain herniates into another

75
Q

What can cause Herniation

A

Cerebral edema

Mass

76
Q

Clinical manif of Herniation

A

Fixed and dilated pupils

77
Q

T/f - brain Herniation is fatal

A

True

78
Q

Def dementia

A

An organic mental disorder char by a cluster of cognitive impairments that are generally gradual onset
Usually irreversible

79
Q

Clinical manif of dementia

A 
Decr attention span
Disorientation
Inappropriate behavior
Labile affect
Restlessness
Agitation
80
Q

Care of a dementia pt requires

A 
Constant reorientation
Simple communications and interactions 
Cautions with meds
More assistance with ADLs 
CM & SW involvement
81
Q

Stroke risk factors

A

Smoking doubles risk
Afib - 5 fold
HTN- most significant

82
Q

What actions give the stroke pts the best chance for survival

A

Administration of TPA within 3 hrs

83
Q

Def stroke

A

An acute neurological impairment that occurs following an interruption of blood supply to a specific region of the brain

84
Q

How are strokes classified

A

Ischemic

Hemorrhagic

85
Q

How are ischemic strokes classified

A

Anterior circulation

Posterior circulation

86
Q

Describe anterior circulation

A

Stroke that follows an occlusion of the carotid artery

Usually involve the cerebral hemispheres

87
Q

Describe the posterior circulation

A

Stroke that follows an occlusion of the vertibrobasilar artery
Usually involved the brain stem or cerebellum

88
Q

Def ischemic stroke

A

A result of an occlusion within the blood vessel

89
Q

What are the most common type of stroke

A

Ischemic stroke

90
Q

Ischemic strokes further classified as

A

Thrombotic
Embolic
Flow disturbance- hypo perfusion

91
Q

Describe thrombotic stroke

A
  • Thrombus forming process in the affected artery

- thrombus gradually narrows vessel and impedes blood flow to distal tissues

92
Q

The s&s of thrombotic ischemic stroke are gradual or acute

A

Usually gradual

93
Q

Risk factors for thrombotic stroke

A 
Atherosclerosis
HTN
Cad 
Vasoconstriction
Dissection of the artery
94
Q

Def embolic stroke

A

Stroke caused by a traveling particle in the arterial bloodstream originating from somewhere else in the body

95
Q

Embolisms can be made of ….

A

Blood clot
Plaque
Air
Bacterial emboli

96
Q

Risk factors for embolic stroke

A 
Afib, PAf , sustained flutter
DVT, PE 
Rheumatic mitral or aortic valve disorders 
Prosthetic or mechanical heart valves
Symptomatic CHF with ef < 30
Dilated cardiomyopathy
Infective endocarditis
CABG 
Pt foremen ovale
97
Q

Def flow disturbance hypoperfusion

A
  • Inadequate cerebral flood flow due to decr BP or due to hematologic hyperviscosity
  • reduction in blood flow is global and may affect all parts of the brain
  • blood flow to these areas may not necessarily stop but may lessen to the point of damage
98
Q

Risk factors for flow disturbance hypoperfusion

A
  • CO, pump failure
  • AMI
  • unstable arrhythmias
  • polycythemia Vera
    Sickle cell
99
Q

Def penumbra

A
  • area surrounding the center of infarction

- this area of damage so potentially reversible

100
Q

Def transient ischemic attacks

A
  • Neuro deficits thT resolve in 24 h
  • 80% resolve within 60 minutes
  • precede 30% of ischemic strokes
101
Q

What can happen if TIA’s are not treated

A
  • can lead to ischemic stroke
    20% within the first month
    50% within the first year
102
Q

Def carotid endardectomy

A
  • gold standard for preventing a stroke from carotid stenosis
  • surgeon removes lacquer from arterial media
  • area is then irrigated and the debris is removed
  • sometimes a patch is placed
103
Q

Candidate criteria for endardectomy

A

Asymptomatic carotid artery disease
TIA, Stroke
Recurrent Carotid Artery disease

104
Q

Can a pt who had a recent stroke secondary to thrombus have CEA and why?

A

No, must wait a few weeks

Increased risk for stroke extension

105
Q

CEA complications

A 
BP deviation-can cause a carotid bleed out
Hyperperfusion syndrome- h/ a's common
Cranial nerve injuries
Re op for bleeding
Restenosis
106
Q

Carotid stents

A
  • for the tx of high risk on surgical patients with high grades of symptomatic carotid artery stenosis
107
Q

What is used in conjunction with carotid stents

A

Angioplasty- prevents the loose of debris and flatten the plaque against the wall of the vessel

108
Q

Nursing protocols after stent/ angio

A 
Hydration to counteract the dye
D/c 48 hrs post op
Restart on ASA and plavix 
Heparin drip for first 24 hrs
Check pt/ ptt / inr q 6 h
Keep leg straight for 6 hrs
Check Neuro q 2 h
109
Q

Potential complications of stents

A 
Femoral site bleeding
Hematoma
Aneurysm
 TIA
Stroke 
Restenosis
110
Q

Def hemorrhagic stroke

A

Occurs when a bv in the brain ruptures or bleeds

111
Q

Effects of hemorrhagic stroke

A
  • incr ICP: decreases blood flow to brain tissue
112
Q

Which stroke is more fatal: ischemic or hemorrhagic

A

Hemorrhagic

113
Q

List types of hemorrhagic strokes

A
  • ICH - intracranial hemorrhage

- SAH- subarachnoid hemorrhage

114
Q

Def intracranial hemorrhage

A

Bleeding directly into the brain tissue, forming a gradually enlarged hematoma
- mortality 44% after 30 days

115
Q

Most common causes of intracranial hemorrhage

A 
HTN 
Trauma
Bleeding disorders
Illicit drug use
Vascular malformations
116
Q

Def subarachnoid hemorrhage - SAH

A

Bleeding into the CSF of the subarachnoid space surrounding the brain ( not the brain itself)

  • bleeding lasts a few seconds but rebleeding is common
  • 40% mortality within 30 days
117
Q

Common causes of SAH

A
  • Rupture of aneurysms from the base of the brain

- bleeding form vascular formations

118
Q

Dx ing of a stroke

A
  • based on clinical assessment
  • imaging- helps determine the type of stroke
    CT- mandatory and emergent
    - will tell if hemorrhagic or embolic
    - if hemorrhagic, cannot give TPA
    MRI
  • carotid u/s
  • echo
  • TEE
  • EKG
119
Q

How do lab studies help in dx ing a stroke

A

They don’t diagnose but rather help find the underlying cause

120
Q

Physical exam for a stroke

A
  • time of onset
  • meds
  • med hx
  • Neuro exam
  • Glasgow is LOC
121
Q

What is NIHSS

A
  • national institute of health stroke scale
  • rapid and reproducible tool for quantifying Neuro deficits
  • 11 item ordinal scale ( score 0- 42)
122
Q

What is of paramount importance when considering a stroke pt for thrombolytic therapy

A

Time of onset

123
Q

What is the avg time frame that a stroke pt presents in the ED

A

4- 24 hrs

124
Q

Reasons for delay in seeking care post stroke

A
  • wake up stroke
  • recognition of s&s - go unrecognized
  • may leave pt too incapacitated to call for help
125
Q

S&s of a stroke

A

Sudden onset of : hemiparesis, monoparesis, quadriparises
Facial assymmetry
Monocular/binocular vision loss, visual field deficits, diplopia
Dysarthria(diff w/ speech)
Ataxia- unsteady gait
Vertigo
Aphasia- diff comprehending/prod language
Decr in LOC
sever h/a- usually assoc with bleed

126
Q

Left hemisphere stroke s&s

A 
Dominant
Aphasia
Right hemiparesis
Right sided sensory loss
Right visual field defect
Dysarthria 
Poor right conjugate gaze
Diffic reading, writing, calc
127
Q

Right hemisphere stroke

A 
Non- dominant
Neglect of left visual space
Left hemiparesis, 
Left sensory loss
Left visual field def 
Dysarthria
Spatial disorientation
Extinction of left sided stimuli
128
Q

Acute Neuro complications of a stroke

A

Cerebral edema
Incr ICP
seizures
Hemorrhagic conversions

129
Q

Def cerebral edema

A

Accum of fluid in ECF and ICF, causing increase in brain volume
- death post stroke is commonly caused by cerebral edema / incr ICP

130
Q

When does cerebral edema usually occur

A

3-5 days post stroke

131
Q

What solutions cannot be used for stroke pts and why

A

Solutions with glucose

  • LR, NS, hypotonic
  • increases ICP
132
Q

What medication is used to decr ICP

A

Mannitol

- rapid and temporary

133
Q

What is usually the first sign of cerebral edema

A

Change LOC

134
Q

When do post stroke seizures occur (if they occur)

A

Usually within 24 hrs

135
Q

What kind of stroke usually occurs post stroke

A

Partial seizures

136
Q

What is the initial tx for seizure post stroke

A

Dilantin 20 mg/ kg IVPB - up to 50/ min

137
Q

What can you give status epilepticus

A

Lorazepam 1-2 mg

Diazepam

138
Q

Def hemorrhagic conversion

A

Conversion of ischemia stroke to hemorrhagic state

139
Q

What increases the chances of hemorrhagic stroke conversion

A

Anticoagulants and thrombolytics

140
Q

NYSDOH & TJC guidelines for stroke protocol

A
  • triage to er md eval - 10 mins
  • door to ct scan- 25 mins
  • triage to meds- 60 mins
141
Q

Standardized stroke protocol set

A
  • DVT proph, dc anticoag ther
  • anti thrombotic therapy by day 2
  • dc statin meds
  • dysphagia screening
  • stroke edu
  • smoking cessation
  • assess for rehab
142
Q

What labs should you run for a stroke

A

CBC
Bmp
Coags
T&s

143
Q

FAST(stroke)

A

F- face- drooping face, loss sudden loss of vision
A- arm- weak/ drooping arm
S-speech- inability to understand/ be understood
T- time- time of onset of symptoms, witnessed, call RRT

144
Q

What is the most important priority for stroke pts

A

Maintain airway

  • loss of protective reflexes or oral-pharyngeal reflexes
  • hob > 30
  • suction prn
  • o2 sat assessment
145
Q

S&s of dysphagia(inability to swallow)

A 
Weak/absent gag reflex
Drooling, excessive chewing
Difficulty pushing food to back of mouth
Dysarthria- dif speaking 
Voice- gurgle,wet,hoarse, strident 
Parasthesia of face, lips, tongue
146
Q

What is Modified Massey Bedside Swallow Test

A
  • indicated for all stroke/ Tia pts
  • within 24 hrs of admission
  • documenting +- alone is not acceptable
  • must be done by RNA
  • when in doubt, keep NPO
147
Q

What is a very serious complication of CVA

A

Pneumonia

148
Q

Dx of post cva PNA

A 
Fever
Incr WBC above 10,000
Rales
\+ sputum C&S 
Productive cough
PaO2 < 70 mm hg
Cxr
149
Q

Oral care for cva pts

A
  • am/pm
  • q 2 hrs for incubated/ trach pts
  • assessment of mucosa
  • peridex
  • ETOH free mouthwash
  • toothpaste
150
Q

Medications administered for reflux

A

Proton pump inhibitors
Antacids
Histamine blockers

151
Q

Diet for dysphagia I

A

Puréed food

Little to no chewing

152
Q

Diet for dysphagia II

A
  • mechanically altered
  • semi solids
  • ground meats
    Require some chewing
153
Q

What is the time window for admin anti thrombotics

A

3 hrs

154
Q

What do you assess after admin TPA

A

Monitor for bleeding
Maintain BP
Monitor Neuro status for change in LOC

155
Q

What can you not use and/ or admin within 24 hrs of a anti thrombotics

A

Scds,
BP cuff
Heparin

156
Q

What is anti thrombotics are indicated for non qualified TPA pts

A

ASA- 150-325 mg

157
Q

What anti thrombotics are indicated for non e

Eligible TPA pts who are immobilized

A

LMWH- prophylactic low dose SQ
Ipc- intermittent pneumatic compression
Coumadin

158
Q

What condition may be protective during or after stroke

A

Hypothermia

159
Q

Anti thrombotics that are indicated for day 2 post cva/Tia

A 
ASA
agrenox
Coumadin
Plavix 
Ticlid
IV heparin 
LMWH- full dose
160
Q

Long term anti thrombotic therapies

A
  • coumadin ( 2-3)

- ASA 75-325 mg/ day

161
Q

What is the modified rankin scale

A
  • scale for measuring the degree of disability or dependance in ADL”s
  • used to eval stroke outcomes and trials
  • added in 2012 for dc of stroke pts
162
Q

Def hemiparesis

A

Weakness of face, arm, and leg on one side

163
Q

Hemiplegia

A

Paralysis of face, arm, leg on one side

164
Q

What is CN I and what does it control

A

Olfactory

- sense of smell

165
Q

How do you test olfactory nerve

A

Place strong scented tie,s under nares bilaterally and ask pt to identify it

166
Q

What is CN II and what does it control

A

Optic

- visual acuity

167
Q

How do you test the optic nerve

A

Smelled chart @ 14”

168
Q

What is CN III and what does it control

A

Oculomotor

- rxn to light

169
Q

How do you test the oculomotor CN

A
  • pen light
  • side to inward: pupil accommodation
  • far to near: pupils constrict
170
Q

What is CN IV and what does it control

A
  • trochlear

- downward and inward mvmt of eyes

171
Q

How do you test the trochlear nerve?

A
  • have pt follow pen light up, down, sideways, diagonal w/o moving head
172
Q

What is CN V and what does it control

A

Trigeminal

Sensation of the face, scalp, cornea

173
Q

How do you test the trigeminal nerve

A
  • touch lateral sclera and observe for blinking
  • cotton ball to forehead, maxillary (cheeks), and chin: should be able to sense cotton ball and distinguish sharp from dull sensations
  • ask pt to clench teeth
174
Q

What is CN VI and what does it control

A

Abductees

Lateral eye mvmt

175
Q

How do you test the abducens nerve

A

Ask pt to move eyeball laterally

176
Q

What is CN VIII and what does it control

A

Facial

  • taste on anterior 2/3 of tongue- sweet, salty, bitter
  • facial mvmt
177
Q

How do you test the facial nerve

A
  • have pt test sweet, salt, and bitter
    Sugar, salt, coffee
  • have pt smile, frown, raise eyebrows, and puff cheeks
178
Q

What is CN IX and what does it control

A

Glossopharyngeal

  • posterior 1/3 of the tongue
  • sensation of eardrum to canal
  • gag response
179
Q

How do you test the glossopharyngeal nerve

A
  • gag reflex
  • “Ka” and “ go”
  • tongue side-side, and up-down
  • swallow
180
Q

What is CN X and what does it control

A

Vagus nerve

Sensation of the pharynx, viscera, carotid body, carotid sinus

181
Q

How do you test the vagus nerve

A

Swallow

182
Q

What is CN XI and what does it control

A

Accessory nerve

- trapezius + sternomastoid muscle mvmt

183
Q

How do you test the accessory nerve

A
  • shrug shoulder side to side against resistance

- turn head from side to side against resistance

184
Q

What is CN XII and what does it control

A

Hypoglossal

Tongue mvmt for speech, sound articulation, and swallowing

185
Q

How do you test the hypoglossal nerve

A

Have pt stick out tongue and move side to side

Look for atrophy and assymmetry

NUR 329 (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions