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CNUR 203 > Neurological > Flashcards

Neurological Flashcards

1
Q

Another name for stroke?

A

Cerebral vascular accident

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2
Q

Ischemia?

A

inadequate blood flow

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3
Q

What is a stroke?

A
  • ischemia to a part of the brain

- hemorrhage into the brain that causes death of brain cells

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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
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5
Q

blood is supplied to the brain by what two major arteries?

A

internal carotid, vertebral

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6
Q

major cause of stroke?

A

atherosclerosis

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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
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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
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9
Q

whats an ischemic stroke?

A

inadequate blood flow to the brain from partial or complete occlusion of an artery

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10
Q

most common type of stroke?

A

ischemic

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11
Q

how are ischemic strokes divided?

A

by their causality:
thrombotic
embolic

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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
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13
Q

what causes a TIA?

A

microemboli

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14
Q

whats microemboli?

A

clots that are caught while travelling thru the bloodstream and cause blockage in the vessel

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15
Q

what also causes a TIA?

A

plaque

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16
Q

what are the S&S of TIA dependant on?

A

location of the brain thats ischemic

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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
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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
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19
Q

most common type of stroke?

A

thrombotic stroke (branch of ischemic)

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20
Q

how does a thrombotic stroke occur?

A
  • atherosclerosis in cerebral arteries builds up
  • clot forms
  • causing an occlusion
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21
Q

what accelerates atherosclerosis?

A
  • HTN

- DM

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22
Q

does TIA require an intervention?

A

no

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23
Q

whats a lacunar stroke?

A

stroke from an occlusion of an artery deep within the brain

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24
Q

with lacunar stroke, what does the affected artery do?

A

supply blood to tissues

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25
Q

with lacunar stroke is a person usually symptomatic or asymptomatic?

A

asymptomatic

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26
Q

when a person is symptomatic with a lacunar stroke, whatre their symtpoms?

A
  • hemiplegia (paralysis of one side of the body)
  • pure sensory stroke
  • contralateral leg and face weakness with arm and leg ataxia
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27
Q

ataxia?

A

poor muscle coordination

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28
Q

whats an embolic stroke?

A
  • embolus occludes cerebral artery
29
Q

where do emboli originate?

A

within the heart

30
Q

5 major signs of stroke

A 
headache 
dizziness 
vision problems
trouble speaking 
weakness
31
Q

whats a hemorrhagic stroke?

A

bleeding into brain tissue

32
Q

two types of hemorrhagic stroke?

A
  • intracerebral

- subarachnoid

33
Q

intracerebral stroke?

A

bleeding into the brain caused by rupture of a vessel

34
Q

risk factor of intracerebral stroke?

A

HTN

35
Q

S&S of intracerebral stroke?

A

HTN, neuro deficits, headache, N&V, decreased LOC

36
Q

CM of intracerebral stroke?

A
  • deviation of eyes, slurred speech, weakness of one side
37
Q

subarachnoid stroke?

A

intracranial bleeding into CSF caused by rupture of cerebral aneurysm

38
Q

Clinical Manifestations of stroke; motor function? cause?

A 
impairment of 
- gag reflex 
-mobility 
- resp. function
- swallowing + speech 
caused by destruction of motor neurons
39
Q

Clinical Manifestations of stroke; communication;

A
  • aphasia
    -dysphagia
  • dysarthria
    types of aphasia:
  • expressive
  • receptive
  • anomic/amneic
  • global
40
Q

aphasia

A

poor comprehension, can speak

41
Q

dysphasia

A

impaired communication

42
Q

expressive aphasia

A

knows what they want to say, difficulty expressing thoughts thru speech or writing

43
Q

receptive aphasia

A

difficulty understanding spoken or written language, can speak but may be incorrect

44
Q

anomic/amneic aphasia

A

trouble finding correct names for objects, places etc

45
Q

global aphasia

A

loss of all expressive and comprehension

46
Q

dysarthria

A

disturbance in the muscular control of speech

47
Q

clinical manifestations of stroke; affect

A

difficulty controlling their emotions

48
Q

clinical manifestations of stroke; intellectual function

A
  • impaired memory and judgement
  • language problems (left brain stroke)
  • impulsive and move quickly (right brain)
49
Q

clinical manifestations of stroke; spatial partial alterations

A
  • 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
Q

clinical manifestations of stroke; elimination

A
  • most urinary and bowel problems are temporary

- frequent constipation

51
Q

most important diagnostic tool for stroke?

A

MRI and CT (brain imaging)

52
Q

how can you prevent stroke ?

A
  • routine assessments
  • BP control
  • diet and exercise
  • BG control
  • cessation of smoking
  • limiting alcohol
53
Q

drug therapy for stroke?

A
  • anti platetlet drug for those who had a TIA

- aspirin is also common

54
Q

surgical therapy for those with TIA and carotid?

A

transluminal angioplasty

55
Q

why is BP elevated after ischemic stroke?

A

protective response to maintain cerebral perfusion

56
Q

acute care for ischemic stroke?

A
  • monitor pt temp

- good fluid intake 1500 -2000 ml per day

57
Q

acute care for hemorrhagic stroke

A
  • anticoags and platelet inhibitors are contraindicated

- main drug therapy is management of HTN

58
Q

nursing assessments for those with stroke?

A
  • cardiac
  • resp
  • neuro
59
Q

nursing diagnoses for those with stroke?

A
  • decreased intracranial adaptive capacity
  • risk for aspiration
  • impaired physical mobility
  • impaired urinary elimination
  • impaired swallowing
  • low self esteem
60
Q

what conditions increase risk for stroke?

A
  • AF
  • HTN
  • TIA
61
Q

which of the factors related to cerebral blood flow most often determines the extent of cerebral damage from a stroke?

A

degree of collateral circulation

62
Q

what info provided by the client would help differentiate between hemorrhagic and ischemic?

A

sudden onset of severe headache

63
Q

a client with right sided hemiplegia and aphasia resulting from a stroke most likely has involvement with what?

A

left middle cerebral artery

64
Q

a client with stroke is scheduled for angiography. what can this test detect?

A

patency of the cerebral blood vessels

65
Q

what is the purpose for a carotid endarterectomy?

A

to prevent a stroke by removing atherosclerotic plaques blocking cerebral blood flow

66
Q

for a person who is suspected to have had a stroke, what is the most important info to collect?

A

time of which stroke symptoms first appeared

67
Q

what does bladder training in a male client who has urinary incontinence after a stroke include?

A

stand when voiding

68
Q

most common response of a client who sustained a stroke regarding the change in body image?

A

depression

CNUR 203 (4 decks)

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