Stroke Flashcards
what is ischemia?
inadequate blood flow to a part of the brain
what is vital to know about stroke?
early recognition is ital to ensure medical intervention is timely
how does a stroke happen?
watch YouTube video
what are some non modifiable stroke factors?
age, sex, indigenous, africana and south asian
what are some modifiable stroke factors?
diabetes mellitus
dyslipedemia
hyerptension
what is the number 1 cause of stroke?
hypertension
what is an ischemic stroke?
inadequate blood flow to the brain from partial or complete occlusion of an artery
what are 3 types of ischemic stroke?
WATCH YouTube
1) transient ischemic attack
2) thrombotic stroke
- most common and most associated with HTN and DM
3) embolic stroke
- fast and no warning sign
what are 2 types of hemorrhagic strokes?
Result from bleeding into the brain tissue itself or into the
subarachnoid space or the ventricles
1) intracereberal hemorrhage
- bleeding within the brain caused by rupture of a vessel
- HTN is the most important factor and commonly occurs during periods of activity
2) subarachnoid hemorrhage
- intracranial bleeding into the CSF-filled space
- Commonly caused by rupture of a cerebral
aneurysm
what are the differences clinical manifestations between ischemic and hemorrhagic stroke?
manifestations do NOT significantly differ
Functions affected are directly related
to artery involved and the area of the
brain it supplies
but do know, right side stroke affects the left side of the body BUT only affects right eye
left side stroke affects the right side of the body BUT only affects the left eye.
what are the actual stroke clinical manifestations?
1) motor function
2) spatial-perceptual alterations
3) communication
4) intellectual function; left side more memory process and right side of brain more impulsive
5) affect: difficulty controlling emotions
6) elimination ; hard time pooping and peeing but this is temporary
what is the nursing assessment completed for stroke?
using the Canadian neurological scale to assess level of consciousness
why do we do the Canadian neurological scale to assess LOC?
Confirm that it is a stroke and not another brain lesion, such as a subdural hematoma
* Identify the likely cause of the stroke
what is the diagnostic machine used?
Gold standard is CT-scan
how do nurses reduce the incidence of stroke?
nurse should focus teaching on stroke prevention. Usually done in particularly in persons with known risk factors. Early signs education needed
F - face; is it drooping?
A - arms; can you rise both?
S - speech; is it slurred?
T - time; call 911 right away
what the the 3 intervention therapy for strokes?
1) primary prevention is decreasing morbidity and mortality from stroke
- BP control, blood sugar control, diet and exercise and smoking cessation
2) medication therapy
- prevent the development of thrombus or embolus so anti platelet, anticoagulation
3) surgical intervention for patients with TIAs from carotid disease
- angioplasty wich is a stent insertion
what is acute care for ischemic stroke?
goal is to preserve life and further prevent brain damage and reducing disability
MOST IMPORTANT POINT IN PT’S HISTORY IS THE TIME OF ONSET
All patients with possible stroke will be assessed will receive
thrombolytic therapy within 4.5 hours from the onset of their
symptoms to achieve this goal
why is TPA given when ischemic stroke occurs?
it is a clot buster BUT you need to to make sure the patient is screened for hemorrhage because this will increase risk of bleeding.
NO anticoagulant or antiplatelet meds for 24 hours post tPA
what is acute care for hemorrhagic stroke?
1) medication therapy
- DO NOT give anticoagulation and antiplatelets so to manage HTN use oral and IV agents
2) surgical therapy
- immediate evacuation of aneurysm-induced hematoma or cerebellar hematoma > 3cm
- coiling or clipping of an aneurysm to prevent rebreeding
watch YouTube video for this
what are we keeping in mind in terms of assessments?
ABCs and neuro assessments to monitor any changes
what is the biggest risk the pt faces after a stroke?
DVT so the most effective prevention is keeping the patient moving
what about musculoskeletal system changes to help patient?
in acute phase help with passive ROM exercises
what about bowels and urinary system?
constipation is the most common bowel condition
for urinary - incontinence so efforts need to be made to promote normal bladder function
what about nutrition and communication?
nutrition swallowing assessment is needed
The nurse’s role in meeting
psychological needs of the patient
is primarily supportive. assessment for the pt’s ability to speak and understand is completed
what is patients with stroke on right side of brain?
Difficulty in judging position,
distance, and movement
* Impulsive, impatient, and
denying problems related to
stroke
* Respond best to directions
given verbally
what is patients with stroke on the left side of the brain?
Slower in organization and
performance of tasks
* Impaired spatial discrimination
* Have fearful, anxious response
to stroke
* Respond well to nonverbal
cues
