Neurological Disorders: 10 questions- Dr. Landerfelt

Question 1

Ischemic Stroke

What is it?

2 types of ischemic stroke?

Answer 1

Result of inadequate blood flow to brain from partial or complete occlusion of an artery (Atherosclerotic plaques)

• Thrombotic: most common (plaque)
• Embolic (clot)

Question 2

Ischemic Stroke:
1. Embolic Stroke

Emboli originate where?

What increased risk for embolism stroke?

Answer 2

2nd most common cause of stroke

Emboli originate in endocardial layer of heart, rheumatic heart disease

Atrial fibrillation ↑ risk for embolism stroke

Question 3

Risk factors of a CVA

Modifiable

what’s number 1 and 2 cause?

Answer 3

HYPERTENSION IS #1
DIABETES IS #2

• Heart disease and dysrhythmias
  (atrial fibrillation)
• Hypercholesterolemia
• Hypercoagulopathy
• Physical inactivity
• Obesity
• Sleep apnea
• Poor diet
• Smoking
• Some oral contraceptives (especially
  with smoking)
• Alcohol and drug abuse

Question 4

Risk factors of a CVA

Non-modifiable (10% of strokes)

Answer 4

Age: Risk doubles each decade after 55

Biologic sex: Biologic males > biologic females

Heredity/family history

History of prior stroke

Question 5

Signs and symptoms of ischemic CVA

Neuro deficits?

onset?
warning signs?
is patient conscious or unconscious?
recurrence?

Answer 5

Neuro deficits:
Sudden onset of dizziness,
Headache
one-sided facial droop
muscle weakness
slurred speech
numbness
vision loss
language disturbances
difficulty maintaining balance

Sudden onset with severe manifestations

Lack of warning signs

Patient usually conscious (HA)

Prognosis related to amount of
brain tissue deprived of blood
supply

Recurrence common

Question 6

Post stroke complications & nursing care for a client after a stroke

Answer 6

• Airway #1
• Breathing
• Circulation

NONCONTRAST head CT/MRI STAT

Important to confirm ischemic and not hemorrhagic bc TPA ↑ risk for bleeding

Question 7

Diagnostic studies for a client with multiple sclerosis

Monitor glucose levels!!!

Answer 7

History and physical

-2 or more “attacks” in different
areas

MRI of brain and spinal cord

-Plaques, inflammation, atrophy

-2 or more demyelinating lesions
in at least 2 different locations

Question 8

Clinical presentation of a client with ALS

Answer 8

Slowly progressive weakness, fatigue, and muscle atrophy

Often begins with muscle twitching and weakness in a limb

Spasticity, stiffness, impaired fine motor control

Dysphagia, dysarthria, dysphonia (difficulty producing sounds at
the level of the larynx, often resulting in hoarseness).

Slurred speech

Eventually affects control of the muscles needed to move, speak, eat and breathe

Question 9

Caring for a client with homonymous hemianopsia

Answer 9

Blindness that occurs in the same half of the visual fields of both eyes.

*Left brain stroke leads to loss of right ½ of the visual field of each eye.
* Right brain stroke leads to loss of the left ½ of the visual field of each eye

Prevent corneal abrasions with artificial tears or gel
*Wear eye shield at night

Question 10

Effective communication with a client with expressive aphasia

Loss of ability to understand or express speech

Answer 10

Speech-language pathologist consult, whiteboard and marker for writing

Question 11

Akinesia

Answer 11

loss of control of voluntary muscle movements

Question 12

Hemiplegia

Answer 12

paralysis of the face, arm ,and leg on the same side of body

Question 13

Hemiparesis

Answer 13

Weakness on one side of body

Question 14

Paraplegia

Answer 14

Paralysis of the lower body typically caused by spinal cord injury/stroke

Question 15

Aphasia

Answer 15

loss of ability to understand and express speech