Neurological Flashcards
1
Q
Another name for stroke?
A
Cerebral vascular accident
2
Q
Ischemia?
A
inadequate blood flow
3
Q
What is a stroke?
A
- ischemia to a part of the brain
- hemorrhage into the brain that causes death of brain cells
4
Q
common long term disabilities with stroke?
A
- hemiparesis (paralysis of one side of the body)
- inability to walk
- dependance in ADL
- aphasia: inability to communicate
5
Q
blood is supplied to the brain by what two major arteries?
A
internal carotid, vertebral
6
Q
major cause of stroke?
A
atherosclerosis
7
Q
non modifiable risk factors for stroke?
A
age gender race ethnicity family hx heredity low birth weight risk increases with age male sex
8
Q
modifiable risk factors for stroke?
A
HTN heart disease DM overweight early forms of birth control increased serum cholesterol and carotid stenosis smoking heavy alcohol use pregnancy
9
Q
whats an ischemic stroke?
A
inadequate blood flow to the brain from partial or complete occlusion of an artery
10
Q
most common type of stroke?
A
ischemic
11
Q
how are ischemic strokes divided?
A
by their causality:
thrombotic
embolic
12
Q
whats a TIA?
A
- a precursor
- temp. episode of neuro dysfunction caused by brain, spinal cord or retinal ischemia but without acute infarction (tissue death) of the brain
- symptoms last less than an hour
13
Q
what causes a TIA?
A
microemboli
14
Q
whats microemboli?
A
clots that are caught while travelling thru the bloodstream and cause blockage in the vessel
15
Q
what also causes a TIA?
A
plaque
16
Q
what are the S&S of TIA dependant on?
A
location of the brain thats ischemic
17
Q
S&S of when the carotid system is ischemic?
A
- temp. loss of vision in one eye
- transient hemiparesis
- numbness/loss of sensation
- inability to speak
18
Q
S&S of when the vertebrobasilar system is ischemic?
A
- tinnitus (ringing noises)
- vertigo
- darkened or blurred vision
- diplopia (double vision)
- ptosis (drooping eyelid)
- dysarthria (disturbance in the muscular control of speech)
- dysphagia (difficulty swallowing)
- ataxia (loss of muscle control)
- numbness or weakness
19
Q
most common type of stroke?
A
thrombotic stroke (branch of ischemic)
20
Q
how does a thrombotic stroke occur?
A
- atherosclerosis in cerebral arteries builds up
- clot forms
- causing an occlusion
21
Q
what accelerates atherosclerosis?
A
- HTN
- DM
22
Q
does TIA require an intervention?
A
no
23
Q
whats a lacunar stroke?
A
stroke from an occlusion of an artery deep within the brain
24
Q
with lacunar stroke, what does the affected artery do?
A
supply blood to tissues
25
with lacunar stroke is a person usually symptomatic or asymptomatic?
asymptomatic
26
when a person is symptomatic with a lacunar stroke, whatre their symtpoms?
- hemiplegia (paralysis of one side of the body)
- pure sensory stroke
- contralateral leg and face weakness with arm and leg ataxia
27
ataxia?
poor muscle coordination
28
whats an embolic stroke?
- embolus occludes cerebral artery
29
where do emboli originate?
within the heart
30
5 major signs of stroke
```
headache
dizziness
vision problems
trouble speaking
weakness
```
31
whats a hemorrhagic stroke?
bleeding into brain tissue
32
two types of hemorrhagic stroke?
- intracerebral
| - subarachnoid
33
intracerebral stroke?
bleeding into the brain caused by rupture of a vessel
34
risk factor of intracerebral stroke?
HTN
35
S&S of intracerebral stroke?
HTN, neuro deficits, headache, N&V, decreased LOC
36
CM of intracerebral stroke?
- deviation of eyes, slurred speech, weakness of one side
37
subarachnoid stroke?
intracranial bleeding into CSF caused by rupture of cerebral aneurysm
38
Clinical Manifestations of stroke; motor function? cause?
```
impairment of
- gag reflex
-mobility
- resp. function
- swallowing + speech
caused by destruction of motor neurons
```
39
Clinical Manifestations of stroke; communication;
- aphasia
-dysphagia
- dysarthria
types of aphasia:
- expressive
- receptive
- anomic/amneic
- global
40
aphasia
poor comprehension, can speak
41
dysphasia
impaired communication
42
expressive aphasia
knows what they want to say, difficulty expressing thoughts thru speech or writing
43
receptive aphasia
difficulty understanding spoken or written language, can speak but may be incorrect
44
anomic/amneic aphasia
trouble finding correct names for objects, places etc
45
global aphasia
loss of all expressive and comprehension
46
dysarthria
disturbance in the muscular control of speech
47
clinical manifestations of stroke; affect
difficulty controlling their emotions
48
clinical manifestations of stroke; intellectual function
- impaired memory and judgement
- language problems (left brain stroke)
- impulsive and move quickly (right brain)
49
clinical manifestations of stroke; spatial partial alterations
- common with right sided stroke
- incorrect perception of self and illness
- erroneous perception of self in space
- agnosia: inability to recognize object
- apraxia: inability to carry out learned movements on command
50
clinical manifestations of stroke; elimination
- most urinary and bowel problems are temporary
| - frequent constipation
51
most important diagnostic tool for stroke?
MRI and CT (brain imaging)
52
how can you prevent stroke ?
- routine assessments
- BP control
- diet and exercise
- BG control
- cessation of smoking
- limiting alcohol
53
drug therapy for stroke?
- anti platetlet drug for those who had a TIA
| - aspirin is also common
54
surgical therapy for those with TIA and carotid?
transluminal angioplasty
55
why is BP elevated after ischemic stroke?
protective response to maintain cerebral perfusion
56
acute care for ischemic stroke?
- monitor pt temp
| - good fluid intake 1500 -2000 ml per day
57
acute care for hemorrhagic stroke
- anticoags and platelet inhibitors are contraindicated
| - main drug therapy is management of HTN
58
nursing assessments for those with stroke?
- cardiac
- resp
- neuro
59
nursing diagnoses for those with stroke?
- decreased intracranial adaptive capacity
- risk for aspiration
- impaired physical mobility
- impaired urinary elimination
- impaired swallowing
- low self esteem
60
what conditions increase risk for stroke?
- AF
- HTN
- TIA
61
which of the factors related to cerebral blood flow most often determines the extent of cerebral damage from a stroke?
degree of collateral circulation
62
what info provided by the client would help differentiate between hemorrhagic and ischemic?
sudden onset of severe headache
63
a client with right sided hemiplegia and aphasia resulting from a stroke most likely has involvement with what?
left middle cerebral artery
64
a client with stroke is scheduled for angiography. what can this test detect?
patency of the cerebral blood vessels
65
what is the purpose for a carotid endarterectomy?
to prevent a stroke by removing atherosclerotic plaques blocking cerebral blood flow
66
for a person who is suspected to have had a stroke, what is the most important info to collect?
time of which stroke symptoms first appeared
67
what does bladder training in a male client who has urinary incontinence after a stroke include?
stand when voiding
68
most common response of a client who sustained a stroke regarding the change in body image?
depression
