Stroke Flashcards
What are the five types of strokes
TIA
Ischemic
Hemorrhagic
Intracerebral
Subarachnoid
What causes a stroke
Disruption in blood supply to part of the brain
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
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
What is a TIA
Transient episode of neurological dysfunction
TIA serves as a warning sign of further ______
Cerebrovascular disease
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
an ischemic stroke results from inadequate ___ ____ to the brain from a partial or complete _____ of an artery
blood flow
occlusion
a thrombotic stroke occurs from injury to a ___ ___ wall & formation of a __ ___
blood vessel
blood clot
thrombotic stroke results from ___ or ____ of a blood vessel
thrombosis
narrowing
thrombotic stroke is the _____ ____ cause of stokes
most common
thrombotic strokes are associated w/ ____ & ____
DM
HTN
an embolic stroke is caused by an _____ which dislodges & ____ a cerebral artery
embolus
occludes
a hemorrhagic stroke results from bleeding into ___ (intracerebral) or ____
brain tissue
subarachnoid space or ventricles
What causes an intracerebral stroke
rupture of a vessel
what is the most common cause of an intracerebral hemorrhage
HTN
s/s of intracerebral hemorrhage (5)
neurologic deficits
headache
nausea, vomiting
decreased levels of consciousness
HTN
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
