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Nursing 353 > Nursing care of patient who had a stroke > Flashcards

Nursing care of patient who had a stroke Flashcards

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1
Q

what is the cause of a hemmoragic stroke?

A

aneurysm in cerebral artery breaks and there is actual bleeding into the brain

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2
Q

Ischemic stroke

A

embolous and blockage of blood flow to a part of the brain. associated with carotid artery.

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3
Q

What is a TIA

A

a small occlusion of a small artery that resolves within 24 hours. usually no permanent damage, considered a forewarning. the attack itself resolves in a manner of minutes.

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4
Q

What is the surgical response for a TIA

A

Carotid endarectomy, removal of arthroscerotic plaque, reopens the carotid vessel. `

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5
Q

What are the indications for a carotid endarterectomy?

A

70-99% occlusion, and a TIA or mild CVA. there are sinigifant risks.

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6
Q

What are the indications for carotid stenting?

A

less invasive, used for TIA candidates that are high surgical risk.

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7
Q

Post op care for carotid endarterectomy?

A

Monitor Vitals and neuro status for cranial nerve impairment.

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8
Q

WHat pulses need to be gotten post surgery for carotid endarterectomy?

A

facial pulses

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9
Q

How do you check for adequate oxegenation and circulation post carotid endarterectomy?

A

O2 sat and polse ox

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10
Q

What do you asses for at site os incision?

A

neck edema, hematoma, tracheal deviation.

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11
Q

How should a post op carotid endarterectomy patient be positions?

A

HOB elevated, off of side of incision to promote drainage of would site.

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12
Q

What can reduce the risk of a CVA by 50%?

A

A healthy lifestyle.

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13
Q

What are warning signs of a CVA?

A

trouble walking, talking, comprehension, paralysis or numbness in face and extremities, vision problems, headache.

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14
Q

What are the human responces in the acute phase of a stroke?

A

change in LOC, presence or absence of voluntary movements, change in quality of RR and pulse, change in ability to speak, visual changes

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15
Q

What are the human responses in post acute phase following a CVA?

A

mental status change (judgement and behavior), loss of motor control, swallowing ability, self care compromise, sensation and perception, changes in nutritional and hydration status, skin.

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16
Q

What do the S&S of a CVA depend on?

A

Size of lesion, amount of collateral blood flow, location of lesion.

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17
Q

What is affected with a stroke in the Frontal portion of the brain

A

movement and personality

18
Q

What is affected with a stroke in the parietal portion of the brain

A

Sensation, awareness of body parts

19
Q

What is affected with a stroke in the Temporal portion of the brain

A

Senses, hearing taste and smell, also interpretation of sound.

20
Q

What is affected with a stroke in the occipital portion of the brain

A

vision

21
Q

What is affected with a stroke in the left hemisphere portion of the brain ?

A

Paralysis/weakness on right side, right visual field affected, aphasia, altered intellectual ability, slow cautious behavior (LEFT BEHIND).

22
Q

What is affected with a stroke in the right hemisphere of the brain ?

A

Paralysis/weakness on left side, left field visual affected, Spatial and perceptual deficits, increased distractibility, impulsive behavior, poor judgement, lack of awareness of ones own deficits. Always RIGHT.

23
Q

What is a CT scan used for

A

gives detailed bone and tissue images, can detect tumors, hemorrhages, fractures, abscesses, hydrocephalus, edema, ventricular and vascular anomalies.

24
Q

what is a cerebral angiogram used for

A

assesses blood vessels of brain, uses contrast dye into artery, series of images, must obtain WRITTEN CONSENT, NPO prior to test.

25
Q

Electroencephalogram EEG

A

Used to check electrical function of brain, seizures, sleep issues, brain waves, brain death.

26
Q

Why do a lumbar puncture on a CVA patient?

A

checking for blood.

27
Q

What is an ischemic clot retrieval?

A

microcatheter sent in and screws into clot to remove it, uses a balloon to prevent blood flow while catching thrombus.

28
Q

What are nursing interventions after a Clot retrieval?

A

KEEP PATIENT FLAT for 4-6 hours to prevent dislodging of clot. TPA, monitor pulse distal to collection site, movement, and temperature of distal portion.

29
Q

What are some prevention options?

A

Clipping of aneurysm.

30
Q

Acute medical care options for CA

A

prevent or minimize risk of bleeding/rebleeding, remove blood clot, re-vascularize brain tissue, assess initial injury

31
Q

Comlications of CVA to be treatedin acute phase of medical care.

A

Seizured, bleeding, bradycardia, respiratory compromise.

32
Q

What is a embollus a result from

A

Fat cellular clumps

33
Q

What is a thrombolic

A

result of vascular atherosclerosis and narrowing of the artery.

34
Q

Management of CVA

A

sedation, reduce ICP with diuretics, maintain CO2 30-35%, position to avoid hypoxia, intubation to maintain airway.

35
Q

When is there a surgical interventio for a CVA?

A

When the hematoma exceeds 3cm and glasgow coma scale score decreases.Clot retrieval, and TPA administration.

36
Q

What does Tissue plasminogen activator do?

A

dissolves blood clot, MUST BE USED within 3-6 hours of stroke.

37
Q

What must be deterimined before usign TPA?

A

nature of stroke, ischemic vs hemmoragic, thrombolitic vs embolitic, assess severity with NIH stroke scale.

38
Q

what are the contraindications for TPA

A

BP>185/110, surgery, cancer, GI bleed, GU bleed.

39
Q

How often is a post stroke patient monitored

A

Q 15 minutes for VS and neuro staus. continuous cardiac monitoring, cerial labs and CT Scan.

40
Q

Nursing care following CVA involves what?

A

Education, primary compromise, collateral compromise, ancillary concerns, compromise prevention.

41
Q

Neuro checks

A

Glasgow coma scale: Eyes, verbal, motor the lower the number the worse it is.

Nursing 353 (13 decks)

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