Stroke

Question 1

what is ischemia?

Answer 1

inadequate blood flow to a part of the brain

Question 2

what is vital to know about stroke?

Answer 2

early recognition is ital to ensure medical intervention is timely

Question 3

how does a stroke happen?

Answer 3

watch YouTube video

Question 4

what are some non modifiable stroke factors?

Answer 4

age, sex, indigenous, africana and south asian

Question 5

what are some modifiable stroke factors?

Answer 5

diabetes mellitus
dyslipedemia
hyerptension

Question 6

what is the number 1 cause of stroke?

Answer 6

hypertension

Question 7

what is an ischemic stroke?

Answer 7

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

Question 8

what are 3 types of ischemic stroke?

WATCH YouTube

Answer 8

1) transient ischemic attack

2) thrombotic stroke
- most common and most associated with HTN and DM

3) embolic stroke
- fast and no warning sign

Question 9

what are 2 types of hemorrhagic strokes?

Answer 9

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

Question 10

what are the differences clinical manifestations between ischemic and hemorrhagic stroke?

Answer 10

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.

Question 11

what are the actual stroke clinical manifestations?

Answer 11

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

Question 12

what is the nursing assessment completed for stroke?

Answer 12

using the Canadian neurological scale to assess level of consciousness

Question 13

why do we do the Canadian neurological scale to assess LOC?

Answer 13

Confirm that it is a stroke and not another brain lesion, such as a subdural hematoma
* Identify the likely cause of the stroke

Question 14

what is the diagnostic machine used?

Answer 14

Gold standard is CT-scan

Question 15

how do nurses reduce the incidence of stroke?

Answer 15

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

Question 16

what the the 3 intervention therapy for strokes?

Answer 16

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

Question 17

what is acute care for ischemic stroke?

Answer 17

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

Question 18

why is TPA given when ischemic stroke occurs?

Answer 18

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

Question 19

what is acute care for hemorrhagic stroke?

Answer 19

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

Question 20

what are we keeping in mind in terms of assessments?

Answer 20

ABCs and neuro assessments to monitor any changes

Question 21

what is the biggest risk the pt faces after a stroke?

Answer 21

DVT so the most effective prevention is keeping the patient moving

Question 22

what about musculoskeletal system changes to help patient?

Answer 22

in acute phase help with passive ROM exercises

Question 23

what about bowels and urinary system?

Answer 23

constipation is the most common bowel condition

for urinary - incontinence so efforts need to be made to promote normal bladder function

Question 24

what about nutrition and communication?

Answer 24

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

Question 25

what is patients with stroke on right side of brain?

Answer 25

Difficulty in judging position,
distance, and movement
* Impulsive, impatient, and
denying problems related to
stroke
* Respond best to directions
given verbally

Question 26

what is patients with stroke on the left side of the brain?

Answer 26

Slower in organization and
performance of tasks
* Impaired spatial discrimination
* Have fearful, anxious response
to stroke
* Respond well to nonverbal
cues