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NUR 406 > Stroke > Flashcards

Stroke Flashcards

1
Q

what is another name for a stroke

A

cerebral vascular accident

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2
Q

what is a stroke

A

problem with blood supply to the brain

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3
Q

what are the types of stroke

A

ischemic: thrombotic, embolic, hemorrhagic conversion,
hemorrhagic

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4
Q

what are the risk factors for a stroke

A

HTN
HLP
tobacoo use
DM
race
oral contraceptives
age
male
hx of TIA
A fib
sickle cell anemia

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5
Q

what are the manifestations of CVAs

A

numbness or weakness on one side of body
sudden confusion
trouble speaking
slurred speech (dysarthria)
trouble seeing
ataxia
severe headache

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6
Q

what is an ischemic stroke

A

occlusion of cerebral caused by a thrombus or embolus
- manifestations will depend on where the occlusion is

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7
Q

what is the patho of an ischemic stroke

A

decrease in blood supply
oxygen deprivation
neuro deficits within 1 min
continued loss of supply leads to irreversible damage

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8
Q

what are the causes of an thrombotic ischemic stroke

A

atherosclerosis
hypercoaguable state

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9
Q

what are the causes embolic ischemic stroke

A

cardiac source:
- mural thrombus
- A fib
- venous clot if atrial septal defect or patent foramen ovale
- thrombus of vegetation of valves
carotid plaque –> carotid bruit

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10
Q

what is a penumbra

A

ischemic area that is still viable
- area around the blockage that is still able to be saved

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11
Q

how long do you have to save the penumbra

A

3 hours

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12
Q

what is a hemorrhagic stroke

A

bleeding within the brain parenchyma caused by a ruptured vessel

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13
Q

what is the most common cause for a hemorrhagic stroke

A

long standing severe HTN

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14
Q

what is another risk of a hemorrhagic stroke

A

aneurysm

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15
Q

what is the difference between a hemorrhagic and ischemic CT scan

A

ischemic: dark shaded area
hemorrhagic: big white spot

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16
Q

what happens during a hemorrhagic stroke

A

large area fills e blood causing
- inc intracranial pressure with inflammation
- herniation
- death

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17
Q

what is the prognosis for someone with a hemorrhagic stroke

A
  • older age can be a benefit bc the brain is atrophied and allows for more room to swell
  • location and size
  • how rapid the bleed, how much the bleed distorts the brain and shifts it
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18
Q

what are the types of intracranial hemorrhage

A

epidural: above the dura
subarachnoid space
subdural: below the dura

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19
Q

what are the characteristics of an epidural hemorrhage

A
  • typically caused by a skull fracture
  • arterial
  • injury is usually less severe
  • bleeds a lot
20
Q

what are the characteristic of a subdural hemorrhage

A
  • typically bridging viens
  • brain moves within the skull, vessels don’t
  • rapid decline, severe injury
  • can be slow: 2-10 days later
21
Q

what are the characteristics of a subarachnoid hemorrhage

A
  • space between the outer arachnoid membrane and pia mater
  • area filled with CSF
  • rupture of a cerebral aneurysm or arterio-venous malformation at junction
22
Q

why are berry aneurysms and why are they problematic

A

the are small but if they get big enough then they can rupture
- they often form on the brainstem which is not a good place for rupture

23
Q

what is a arterio-venous malformation

A

clumping
one large vein instead of many small

24
Q

what is the presentation of a hemorrhagic stroke

A

30-60 yo, high morbidity/mortality, serious disabilities
terrible headache
irritation of the meninges
- nuchal rigidity
- photophobia

25
Q

what will be found in the CSF if there is a subarachnoid hemorrhage

A

blood

26
Q

what is a risk with a subarachnoid hemorrhage

A

risk of rebleed within the first 24 hrs

27
Q

what are the ways to remove an aneurysm

A

clip it
platinum coil

28
Q

what is BE FAST

A

Balance: along with headache and dizzy
Eyes: sudden loss of vision (one or both)
Face: symmetry
Arm: weakness
Speech: difficulty
Time: time to call 911

29
Q

what is the treatment evaluation for a stroke

A

3 hours is key
recognition of sx
ability to get to therapy

30
Q

what is the class of alteplase

A

fibrinlytics

31
Q

what is the moa of alteplase

A

promotes conversion of plasminogen to plasmin

32
Q

what is alteplase used for

A

acute MI
PE
ischemic strokes

33
Q

what is the route of alteplase

A

IV

34
Q

what do you need to monitor after giving alteplase

A

BP and HR

35
Q

what are the adverse effects of alteplase

A

inc risk of intracranial bleeding

36
Q

what is the antidote for alteplase

A

aminocaproic acid –> anti thrombolytic

37
Q

what are the functions of the left brain

A

logic, verbal, detail, science, names, math, strategies, order, thinking, write, communication, analytics

38
Q

what are the functions of the right brain

A

pictures, stories, big picture, observations, shapes, music, patterns, beauty, imagination, possibilities, art

39
Q

what are potential consequences of a stroke

A

dysphagia
motor and sensory deficits
flaccidity
spasticity
visual disturbances
- contralateral field blindness
- homonymous hemianopia
aphasia
depression
memory and behavioral problems

40
Q

what is aphasia

A

some degree of inability to speak or to comprehend

41
Q

what is dysphasia

A

impairment of speech

42
Q

what is dysarthria

A

imperfect speech sounds
- word finding problems
- incorrect use of verbs

43
Q

what is expressive aphasia

A

comprehension intact but cannot express

44
Q

what is receptive aphasia

A

can communicate but cannot comprehend
- what is being said “can’t recieve”

45
Q

what are the behavioral problems that can come up after a stroke

A

inc emotional response
may underestimate own abilities
slow rxn times
hesitant and cautious
may be apathetic, confused, disoriented

NUR 406 (15 decks)

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