Stroke Flashcards by Katelyn Kelley

What are the five types of strokes

TIA
Ischemic
Hemorrhagic
Intracerebral
Subarachnoid

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What causes a stroke

Disruption in blood supply to part of the brain

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What are the non-modifiable risk factors for a stroke (4)

Age
Gender: more common in men
Ethnicity: higher incidences in African Americans
Hereditary/family history

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What are the modifiable stroke risk factors (11)

HTN, history at TIA
Cardiovascular disease
Diabetes
Smoking, alcohol, substance abuse
Birth control pills, hormone replacement
Obesity
Sleep apnea

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What is a TIA

Transient episode of neurological dysfunction

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TIA serves as a warning sign of further ______

Cerebrovascular disease

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After having a TIA 1/3 will _____ 1/3 ________ & 1/3 _______

1/3 will not experience another event
1/3 have additional TIA’S
1/3 progress to stroke

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an ischemic stroke results from inadequate ___ ____ to the brain from a partial or complete _____ of an artery

blood flow
occlusion

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a thrombotic stroke occurs from injury to a ___ ___ wall & formation of a __ ___

blood vessel
blood clot

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thrombotic stroke results from ___ or ____ of a blood vessel

thrombosis
narrowing

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thrombotic stroke is the _____ ____ cause of stokes

most common

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thrombotic strokes are associated w/ ____ & ____

DM
HTN

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an embolic stroke is caused by an _____ which dislodges & ____ a cerebral artery

embolus
occludes

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a hemorrhagic stroke results from bleeding into ___ (intracerebral) or ____

brain tissue
subarachnoid space or ventricles

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What causes an intracerebral stroke

rupture of a vessel

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what is the most common cause of an intracerebral hemorrhage

HTN

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s/s of intracerebral hemorrhage (5)

neurologic deficits
headache
nausea, vomiting
decreased levels of consciousness
HTN

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What can cause a subarachnoid hemorrhage (3)

rupture of a cerebral aneurysm
trauma
illicit drug use (cocaine)

subarachnoid strokes are higher in which gender

females

for a cerebral vasospasm w/ hemorrhagic stroke, what meds do we admin (2)

calcium channel blocker
nimodipine

hemorrhagic stroke can cause what complications (7)

neuro & systemic complications
cerebral vasospasm
hypnatremia
myocardial ischemia
myocardial infarction
ARDS

s/s of thrombotic stroke (2)

no LOC decreased w/in 1st 24 hrs
symps progressively worse as infarction & edema increase

what are s/s of embolic stroke (3)

sudden severe s/s
warning signs less common
pt remains conscious may have headache

what s/s of hemorrhagic stroke (2)

sudden onset of symps
symps prgress over mins to hrs due to ongoing bleeding

what are motor deficits of strokes (3)

hemiplegia hemiparesis ataxia

what are communication deficits of strokes (3)

dysarthria dysphasia aphasia

what are cognitive impairments of stroke (4)

memory loss decreased attention span poor reasoning altered judgement

what are psychological effects of strokes (3)

loss of self-control depression emotional lability

stroke on rt side of the brain is more likely to cause problems in ____ _____ orientation

spatial perceptual

what is homonymous hemianopsia

unilateral neglect of affected side

what is agnosia

inability to interpret sensations and hence to recognize things, typically as a result of brain damage

what is apraxia

loss of ability to execute or carry out skilled movement and gestures, despite having the physical ability and desire to perform them

what are diagnostic tests for stroke (10)

CT scan MRI Cerebral angiography Digital subtraction angiography Transcranial Dopple ultrasonography Carotid duplex scanning Cardiac imaging, ECG, Chest x-ray CBC Coagulation studies CSF analysis

a CT scan can differentiate b/w _____ & _____ stroke

ischemic & hemorrhagic

what health promotions can we reccommend to prevent stroke (7)

healthy diet wt control regular exercise no smoking limiting alcohol consumption bp management routine health assessments

what are drugs can prevent stroke (6)

antiplatelet drugs Asprin 81 mg oral anticouags warfarin statins antihypertensives

how can we manage ischemic strokes (3)

thrombolytic therapy w/in 3 hrs of s/s noncontrast CT of head blood tests for coag studies screening for hx of GT bleed, strokem or head trauma in past 3 mnths, or major surgery in past 14 days, or active internal bleeding w/in 22 day

what are surgical procedure for ischemic stroke (2)

carotid endarterectomy carotid stenting

what are surgical procedures for hemorrhagic stroke (2)

aneurysm clipping, coliling resection of ateriovenous malformation

what are nursing interventions for stroke (11)

support resp syst frequent neuro exam monitor cardiovascular syst monitor musculoskeletal syst monitor skin breakdown monitor for constipation promote normal bladder function assess & monitor nutritional status be supportive w/ communication efforts initially arrange client's environment w/in their perceptual field give client & family clear explanations

goals for pt & family (9)

improvement of mobility avoidance of shoulder pain achievement of self-care attainment of bladder control improvement of thought process achievement of some form of communication maintenance of skin integrity restoration of family function absence of complications

dress ___ side first for stroke pts

affected

attain bladder control with (4)

bladder retraining program offer urinal/bedpan on schedule avoid use of caths upright posture & standing position for males