Stroke

Question 1

What is a stroke?

Answer 1

Acute neurological deficit due to impaired blood flow to an area of the brain. Results in brain tissue injury .

Question 2

What is a TIA? and symptoms

Answer 2

Transient ischemic attack. It precedes a thrombotic stroke and warns of impending ischemic stroke. Symptoms last between 1-24 hrs: impaired vision, headache, vertigo, problems with speech, weakness/numb/tingling

Question 3

Thrombotic stroke?

Answer 3

Process of clot formation which results into narrowing of lumen/blocks passage of blood through the artery.

Question 4

Embolic stroke?

Answer 4

Embolus is a blood clot/other debris that circulates in blood/reaches artery in brain that’s too narrow so it lodges there/blocks flow.

Question 5

Hemorrhagic stroke?

Answer 5

Burst blood vessel may allow blood to seep into/damage brain tissues until clotting shuts off leaks.

Question 6

Intracerebral hemorrhage?

Answer 6

Bleeding into brain tissue results b/c of sustained HTN

Question 7

FAST test?

Answer 7

Face- drooping?
Arms- can you raise both?
Speech- is it slurred or jumbled?
T- call 911 right away

Question 8

S+S of stroke?

Answer 8

It depends of what area of brain it affect. Numbness/weakness of face/arms, difficulty in balance/speech, loss of vision in one eye. Know LSN. Sudden dizziness/trouble walking and sudden severe headache.

Question 9

Right brain damage?

Answer 9

Stroke on right side of brain= paralyzed left side, left side neglect, impaired judgement, impaired time concepts, and short attention span.

Question 10

Left brain damage?

Answer 10

Stroke on left side of brain= impaired speech, paralyzed right side, slow performance, impaired right life discrimination, impaired comprehension- math, language

Question 11

DX procedures for stroke?

Answer 11

CT scan of the head is the best

Question 12

What to monitor for stroke?

Answer 12

Inadequate perfusion, decreased mobilty, sensory perception deficits, aphasia/dysarthria, oxygenation, serum glucose, blood pressure, ECGs

Question 13

rTPA treatment?

Answer 13

Start within 4.5 hrs of onset of symptoms, can reduce stroke if it is within that period. Don’t give if they had a hemorrhagic stroke. This is a clot busting drug so it has high risk of bleeding.

Question 14

Aspirin and anticoagulants?

Answer 14

As- used for patient with acute ischemic stroke/TIA, start within 48 hrs of onset. It reduces stroke mortality.

An- avoid for 24 hrs after rTPA treatment, used to prevent clots/prevent them from getting bigger

Question 15

What is carotid stenosis?

Answer 15

Hardening/narrowing of artery which decreases blood flow to brain.

Question 16

Ataxia?

Answer 16

Lack of muscle control/coordination.

Question 17

What is dysarthria?

Answer 17

Slurred speech caused by paralysis and muscle weakness.

Question 18

What is aphasia?

Answer 18

Problems with speech

Question 19

Risk factors for strokes?

Answer 19

Smoking, obesity, diabetes, hypertension, elevated cholesterol, and genetics.

Question 20

Can altered LOC be a symptom of l-toxic or hypoglycemia instead of stroke?

Answer 20

Yes

Question 21

What does last seen normal determine for a stroke patient?

Answer 21

Determines eligibility for thrombolytic therapy.

Question 22

Nursing interventions to minimize risk for aspiration because of a stroke?

Answer 22

Assess swallowing ability, elevate HOB during/after meals, use thickened liquids if recommended. You need to assess their swallowing before giving anything by mouth.

Question 23

Is protection of the airway the priority for a patient having an acute stroke?

Answer 23

Yes