Stroke Flashcards
stroke
- A sudden attack of weakness or paralysis occurs when blood flow to an area of the brain is interrupted
- death of brain cells that occurs when there is ischemia to a part of the brain or hemorrhage into the brain
- Damage is irreversible
ischemic stroke
- The most common type of stroke in older people
- occurs when the flow of blood to the brain is blocked by the narrowing or blockage of a carotid artery.
- 83% of strokes are ISCHEMIC
hemmorragic stroke
- bleeding into the brain tissue or subarachnoid space
- 17% of strokes are hemorrhagic
Transient Ischemic Attack (TIA)
- a temporary focal loss of neurological function caused by ischemia of one of the vascular territories of the brain
- lasting less than 24 hrs, often lasts less than 15 minutes
- Effects:
motor
sensory
speech/language
vision
cerebellar disturbances
Risk factors for stroke
- Hx of TIA
- Prior stroke
- Old age
- High blood pressure (HT)
- Smoking or tobacco use
- Diabetes
- Overweight or Obesity
- Excessive alcohol
- Certain medications (stimulants)
- Inactivity
- Atherosclerosis
- Heart disease
- Atrial fibrillation (Afib)
- Blood disorders
Right side of brain
controls emotional expression
spatial perception
recognition of faces
patterns
melodies,
- Creativity
- Imagination
- Music and Arts
- A patient with a right-side stroke may suffer from emotional lability, which includes involuntary outbursts of emotion - a right-brained task.
Left side of brain
- Logic
- Analysis
- Sequencing
- Mathematics
- Language
- Critical thinking
- Reasoning
- Thinking in words
- A patient with left-side stroke may suffer from aphasia, the inability to understand or express language - a left brain task.
Signs and symptoms of a stroke
- paresthesia (numbness, tingling, burning)
- Weakness or paralysis of the limbs
- Aphasia (impairment of language expression and understanding)
- Confusion
- Visual Disturbance in one or both eyes
- Dizziness
- Loss of balance and coordination
- headache
Early warning signs of a stroke
- balance issues
- eyesight issues
- facial drooping
- arm weakness
- slurred speech
- co-ordination
- dizziness
- headache
- paresthesia (numbness, tingling, burning)
- Hemiparesis
weakness of one entire side of the body
- Hemiplegia
complete paralysis of half of the body
- Aphasia
an impairment of language, affecting the production or comprehension of speech and the ability to read or write
- Dysarthria
difficult or unclear articulation of speech. It results from impaired movement of the muscles used for speech production, including the lips, tongue, vocal folds, and/or diaphragm.
- Dysphagia
difficulty or discomfort in swallowing
- Apraxia
a motor disorder where the patient has difficulty with the motor planning to perform tasks or movements despite intact motor function.
- Homonymous hemianopia
a condition in which a person sees only one side―right or left
- Horner Syndrome
caused by the disruption of a nerve pathway from the brain to the face and eye on one side of the body. Normally, patients with Horner syndrome have the following- decreased pupil size, a drooping eyelid and decreased perspiring on the affected side of the face.
- Agnosia
inability to interpret sensations and hence to recognize things
- Unilateral neglect
failure to report or respond to stimuli presented from the contralateral space, including visual, somatosensory, auditory, and kinesthetic sources
Medical interventions for stroke
- Early diagnosis
- Maintain cerebra oxygen
- Restore cerebral flow
- Prevent complications- bleeding, cerebral edema
- Prevention of a second stroke
- Rehabilitation- focus on maximizing patients physical and cognitive recovery
- Patient and family education
Nursing interventions for stroke
Nurse:
- Frequent neurological assessments
- Fall prevention measures
- Prevent aspiration
- HOB at 30 degrees (increase venous return)
- initiate DVT prophylaxis (mechanical & chemical)
- Prevent edema
- Facilitate safe swallowing
- Monitor vital signs
- prevent skin breakdown
- regular position changes in bed
- ambulate the pt standing on their weaker side
For patient:
Teaching/ education on:
- assistive ambulatory devices
- nutrition
- rehab
- promote family coping and communication
treatment of TIA’s
antiplatelet agents reduces the risk of stroke
treatment for ischemic stroke
TPA (tissue plasminogen activator) should be administered within 4.5 hours
FAST
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