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Module 4 > Stroke > Flashcards

Stroke Flashcards

1
Q

ischemia

A

inadequate blood flow

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2
Q

hemorrhage

A

bleeding

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3
Q

causes of stroke?

A

disruption in blood supply to part of the brain

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4
Q

can be classified as what?

A

ischemic or hemorrhagic

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5
Q

non modifiable risk factors for stroke

A

-age
-gender : more common in men
-ethnicity : higher incidence in African Americans
-hereditary / family hx

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6
Q

modifiable risk factors for stroke

A

-HTN!!!!!! (#1)
-history of TIA
-cardiovascular dz (afib, murmurs)
-diabetes
-smoking (vasoconstriction)
-alcohol/substance abuse
-BC pills, hormone replacement
-obesity
-sleep apnea

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7
Q

T or F : more women die from strokes than men

A

true
women live longer

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8
Q

what percentage of strokes are due to modifiable risk factors

A

90%

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9
Q

two types of ischemic strokes

A

thrombotic
embolic

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10
Q

transient ischemic attack is what?

A

normally a precursor to ischemic stroke

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11
Q

what percent of strokes are ischemic?

A

80%

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12
Q

two types of hemorrhagic strokes

A

intracerebral
subarachnoid

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13
Q

what is a thrombotic stroke?

A

injury to blood vessel wall leads to clot formation (thrombosis) which results in narrowing of the blood vessel, which blocks the passage of blood through the artery

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14
Q

what is embolic stroke?

A

embolus = a blood clot or other debris circulating in the blood / when it reaches an artery in the brain that is too narrow to pass through, there is a blockage in the blood flow

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15
Q

what is a hemorrhagic stroke?

A

a burst blood vessel may allow blood to seep into and damage brain tissue until it clots off

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16
Q

what type of stroke is the most common cause/60%?

A

thrombotic

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17
Q

manifestations of ischemic stroke may progress in the first how many house ? as what increases?

A

72 hours
infarction and cerebral edema

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18
Q

what can be a main cause for a thrombotic stroke ? why?

A

DM and HTN
cause plaque buildup

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19
Q

what is the 2nd most common type of stroke?

A

embolic stroke

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20
Q

where does an embolic stroke mostly originate from?

A

endocardial layer of heart - Afib, MI, valve replacement (anticoagulants)

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21
Q

embolic stroke manifestations

A

-sudden onset + severe symptoms
-warming signs less common
-pt usually remains conscious
-headache

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22
Q

prognosis of embolic stroke is related to

A

how long blood flow is lost, can recur if cause is not treated

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23
Q

hemorrhagic stroke - intracerebral hemorrhage is cause by

A

bleeding within the brain caused by a rupture of a vessel

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24
Q

hemorrhagic stroke - intracerebral hemorrhage

sudden/delayed onset?
progression
prognosis

A

-sudden onset of symptoms
-progression over min-hours because of ongoing bleeding
-prognosis = poor

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25
Q

most common cause of intracerebral hemorrhage?

A

HTN

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26
Q

hemorrhage occurs when? (intracerebral hemorrhage)

A

activity

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27
Q

s/s of intracerebral hemorrhage

A

-neuro deficits
-headache
-n/v
-decreased LOC
-HTN

28
Q

subarachnoid hemorrhage (SAH) bleeding where?

A

into CSF filled space between arachnoid and Pia mater

29
Q

SAH often caused by?

A

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

30
Q

hemorrhagic stroke - complication : cerebral vasospasm - administer?

A

ca+ channel blocker - nimodipine

31
Q

true or false - subarachnoid hemorrhage is higher In women

A

true

32
Q

what does nimodipine do ?

A

lower BP

33
Q

why permissive HTN?

A

if you drop BP quickly, it can bottom the pt out abruptly

34
Q

if stroke occurs on the right side of the brain, what side will symptoms be on?

A

left

35
Q

hemiplegia

A

paralysis on left or right side of body (half)

36
Q

hemiparesis

A

partial weakness on one side of the body

37
Q

ataxia

A

lack of muscle control

38
Q

motor deficits from stroke

A

hemiplegia
hemiparesis
ataxia

39
Q

communication deficits for stroke

A

dysarthria
dysphagia
aphasia

40
Q

dysarthria

A

difficulty speaking , muscles affected

41
Q

dysphagia

A

difficulty swallowing/ gag reflex

42
Q

aphasia - 3 types

A

receptive
expressive
global

43
Q

expressive aphasia

A

can understand you, cant respond - cant respond to specific questions

44
Q

receptive aphasia

A

cannot receive or process information

45
Q

global aphasia

A

inability to speak / communicate

46
Q

cognitive impairment from stroke

A

-memory loss
-decreased attention span
-poor reasoning
-altered judgement

47
Q

psychological affects of stroke

A

-loss of self control
-depression
-emotional ability - cant express emotions properly (opposite)
-elimination (incontinent)

48
Q

how do we help with incontinence after stroke?

A

bowel/bladder retraining

49
Q

stroke complications - homonymous hemianopsia

A

blindness on one side
right or left sided

50
Q

right sided brain stroke is most likely to cause what?

A

spatial-perception orientation

51
Q

first scan done to confirm stroke
what can it identify ?

A

CT
hemorrhagic stroke

52
Q

second scan done for more info on stroke after CT? what can it identify?

A

MRI
ischemic stroke

53
Q

what med is held before CTA/MRA?

A

metformin (48hrs before and after)

54
Q

if pt is receiving dye, what do you check for?

A

allergies to shellfish

55
Q

can there be a delayed allergic reaction to dye?

A

yes - check for hot, itchy, red skin, rash

56
Q

one of the most important preventions for stroke

A

manage modifiable risk factors

57
Q

drugs used to prevent stroke

A

-antiplatelet drugs - TIA pts
-aspirin 81 mg (antiplatelet)
-oral anticoagulant for pt with Afib
-warfarin
-statins, antihypertensives

58
Q

ischemic stroke management - thrombolytic therapy

A

-within 3 hrs of s/s
-noncontrast CT
-blood test for coagulation studies
-screening for hx of GI bleed, stroke, head trauma (3 months), surgery (14 days), internal bleeding (22days)
-TPA (tissue plasminogen activator)- break up clots

59
Q

what do we do when pt gets TPA?

A

2 large IV lines, fall bundle, foley
watch VS - BP control
bed rest for 72hrs

60
Q

side effect of TPA

A

-more bleeding (only for ischemic stroke)

61
Q

ischemic stroke surgery

A

-carotid endarterectomy (remove plaque)
-carotid stenting (restore blood blow)

62
Q

hemorrhagic stroke surgery

A

-aneurysm clipping, coiling
-resection of arteriovenous malformation

63
Q

nursing interventions

A

-support resp system (atelectasis, asp. pneumonia, airway obstruction)
-frequent neuro exam (post TPA-at risk for hem stroke, after surgery)
-monitor cardiovascular system
-monitor for skin breakdown
-monitor for constipation
-promote normal bladder function
-assess and monitor nutritional status
-support

64
Q

goals for pt and family

A

-improvement of mobility
-avoidance of shoulder pain
-achievement of self care
-attainment of bladder control
-improvement of thought process
-some form of communication
-skin integrity
-family functioning
-no complications

65
Q
A
66
Q
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67
Q
A

Module 4 (23 decks)

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