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IM 4 > Stroke > Flashcards

Stroke Flashcards

1
Q

What are the five types of strokes

A

TIA
Ischemic
Hemorrhagic
Intracerebral
Subarachnoid

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2
Q

What causes a stroke

A

Disruption in blood supply to part of the brain

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3
Q

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

A

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

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4
Q

What are the modifiable stroke risk factors (11)

A

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

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5
Q

What is a TIA

A

Transient episode of neurological dysfunction

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6
Q

TIA serves as a warning sign of further ______

A

Cerebrovascular disease

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7
Q

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

A

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

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8
Q

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

A

blood flow
occlusion

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9
Q

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

A

blood vessel
blood clot

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10
Q

thrombotic stroke results from ___ or ____ of a blood vessel

A

thrombosis
narrowing

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11
Q

thrombotic stroke is the _____ ____ cause of stokes

A

most common

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12
Q

thrombotic strokes are associated w/ ____ & ____

A

DM
HTN

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13
Q

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

A

embolus
occludes

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14
Q

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

A

brain tissue
subarachnoid space or ventricles

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15
Q

What causes an intracerebral stroke

A

rupture of a vessel

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16
Q

what is the most common cause of an intracerebral hemorrhage

A

HTN

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17
Q

s/s of intracerebral hemorrhage (5)

A

neurologic deficits
headache
nausea, vomiting
decreased levels of consciousness
HTN

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18
Q

What can cause a subarachnoid hemorrhage (3)

A

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

19
Q

subarachnoid strokes are higher in which gender

A

females

20
Q

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

A

calcium channel blocker
nimodipine

21
Q

hemorrhagic stroke can cause what complications (7)

A

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

22
Q

s/s of thrombotic stroke (2)

A

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

23
Q

what are s/s of embolic stroke (3)

A

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

24
Q

what s/s of hemorrhagic stroke (2)

A

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

25
Q

what are motor deficits of strokes (3)

A

hemiplegia
hemiparesis
ataxia

26
Q

what are communication deficits of strokes (3)

A

dysarthria
dysphasia
aphasia

27
Q

what are cognitive impairments of stroke (4)

A

memory loss
decreased attention span
poor reasoning
altered judgement

28
Q

what are psychological effects of strokes (3)

A

loss of self-control
depression
emotional lability

29
Q

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

A

spatial perceptual

30
Q

what is homonymous hemianopsia

A

unilateral neglect of affected side

31
Q

what is agnosia

A

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

32
Q

what is apraxia

A

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

33
Q

what are diagnostic tests for stroke (10)

A

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

34
Q

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

A

ischemic & hemorrhagic

35
Q

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

A

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

36
Q

what are drugs can prevent stroke (6)

A

antiplatelet drugs
Asprin 81 mg
oral anticouags
warfarin
statins
antihypertensives

37
Q

how can we manage ischemic strokes (3)

A

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

38
Q

what are surgical procedure for ischemic stroke (2)

A

carotid endarterectomy
carotid stenting

39
Q

what are surgical procedures for hemorrhagic stroke (2)

A

aneurysm clipping, coliling
resection of ateriovenous malformation

40
Q

what are nursing interventions for stroke (11)

A

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

41
Q

goals for pt & family (9)

A

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

42
Q

dress ___ side first for stroke pts

A

affected

43
Q

attain bladder control with (4)

A

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

IM 4 (62 decks)

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