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IM4 > Stroke > Flashcards

Stroke Flashcards

1
Q

A stroke results in

A

Death of brain cells

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2
Q

How do you know a patient is having a stroke? What signs do you see?

A

“FAST”
- Face droops
- Arm weakness
- Speech difficulty
- Time is critical

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3
Q

What causes a stroke?

A

Disruption in the blood supply to part of the brain

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4
Q

What are strokes classified as?

A
  • Ischemic: inadequate blood flow to brain
  • Hemorrhagic: Bleeding into brain
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5
Q

What are the diagnostic tests for stroke?

A
  • CT 1st
  • MRI
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6
Q

Non modifiable risk factors for stroke

A
  • Age
  • Gender — more common in men
  • Ethnicity — higher in African Americans
  • Hereditary
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7
Q

Modifiable risk factors for stroke

A
  • HTN!
  • CV disease
  • Diabetes
  • Smoking, alcohol, drugs
  • Birth control pills/hormone replacement
  • Obesity
  • Sleep apnea
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8
Q

Types of Stroke

A
  • Transient Ischemic Attack (TIA)
  • Ischemic
  • Hemorrhagic
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9
Q

Transient ischemic attack (TIA)

A

Transient episode of neurologic dysfunction that serves as warning sign of further Cerebrovascular disease

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10
Q

Ischemic strokes are either

A

Thrombotic or Embolic

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11
Q

Define an ischemic stroke

A

Deprivation of oxygen to brain

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12
Q

Ischemic: Thrombotic Stroke

A
  • Occurs from injury to blood vessel wall & formation of a blood clot
  • Results from thrombosis or narrowing of blood vessel
  • Most common
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13
Q

Thrombotic strokes are associated with

A
  • DM and HTN
  • Can be preceded by a TIA
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14
Q

Ischemic: Embolic Stroke

A
  • Embolus dislodges & occludes a cerebral artery
  • Results in infarction and edema of area supplied by involved vessel
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15
Q

What do patients take when they have Embolic stroke?

A

Blood thinners

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16
Q

Embolic stroke mostly originates from

A

The endocardial layer of the heart

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17
Q

Embolic stroke ______ onset

A
  • Sudden onset with severe clinical manifestations
    -Pts usually remain conscious
  • Commonly recur
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18
Q

Hemorrhagic stroke results from

A

Bleeding into
- brain tissue
- subarachnoid space or ventricles

19
Q

Intracerebral Hemorrhage

A
  • Bleeding in brain caused by rupture of vessel
  • Sudden onset
  • Progression over minutes to hours because of ongoing bleeding
20
Q

Intracerebral hemorrhage prognosis

A

Poor with a 30 day mortality rate of 40-80%

21
Q

Intracerebral hemorrhage most commonly caused by

A

HTN

22
Q

Intracerebral hemorrhage manifestations

A
  • Neurological deficits
  • Headache
  • N/V
  • Decreased LOC
  • HTN
23
Q

Subarachnoid hemorrhage

A

Intracranial bleeding into cerebrospinal fluid-filled space between arachnoid and pia mater

24
Q

Subarachnoid hemorrhage often caused by

A

Rupture of cerebral aneurysm, trauma, or illicit drug use
- Incidence increases with age; higher in women
- Silent killer

25
Q

Cerebral vasospasm

A

Administration of calcium channel blocker (Nimodipine)

26
Q

Stroke on right side of brain

A
  • Paralyzed left side : hemiplegia
  • Spatial perceptual deficits
  • Rapid performance, short attention span
  • Impulsive, safety problems
  • Impaired judgement and time concepts
27
Q

Stroke on left side of brain

A
  • Paralyzed right side
  • Impaired speech
  • Slow performance, cautious
  • Aware of deficits (anxiety and depression)
  • Impaired comprehension of language and math
28
Q

Clinical manifestations of stroke

A
  • Motor deficits
  • Communication deficits
  • Cognitive impairment
  • Psychological effects
  • Elimination
29
Q

Motor deficits

A
  • Hemiplegia: complete/severe loss of strength
  • Hemiparesis: mild loss of strength
  • Ataxia: poor muscle control
30
Q

Communication

A
  • Dysarthria: can’t form words
  • Dysphasia: affects ability to understand and use words
  • Aphasia
31
Q

Cognitive impairment

A
  • Memory loss
  • Decreased attention span
  • Poor reasoning
  • Altered judgement
32
Q

Psychological effects

A
  • Loss of self control
  • Depression
  • Emotional lability
33
Q

Stroke on right side of brain is more likely to cause

A
  • Problems in spatial perceptual orientation
  • Agnosia: loss of ability to identify objects or people
  • Apraxia: difficulty with skilled movements
34
Q

What does a CT or MRI tell you?

A

Tells if the stroke is ischemic or hemorrhagic

35
Q

Prevention

A
  • Diet
  • Weight control
  • Exercise
  • No smoking
  • Limit alcohol
  • BP management!! Bc HTN
36
Q

Prevention drug therapy

A
  • Antiplatelet drugs used in pts who have had TIA
  • Aspirin (81mg/day)
  • Anticoagulation for pt w a fib
  • Warfarin
  • Statins, antihypertensives
37
Q

Thrombolytic therapy within

A

3 hours of s/s

38
Q

Surgical management for ischemic stroke

A
  • Carotid endarterectomy
  • Carotid stenting
39
Q

Surgical management for hemorrhagic stroke

A
  • Aneurysm clipping, coiling
  • Resection of arteriovenous malformation
40
Q

Nursing interventions for stroke

A
  • Support resp. system
  • Frequent neuro exam
  • Monitor CV and musculoskeletal system
  • Monitor for skin breakdown and constipation
  • Promote normal bladder function
  • Nutritional status
  • Be supportive w communication
  • Initially arrange clients environment within perceptual field
  • Clear and understandable explanations
41
Q

Achieve self care

A
  • Encourage to assist in personal hygiene as soon as able to sit up
  • Start with affected side
  • Dressing — better balance when seated
  • Use larger clothing
  • Place on affected side — dress first
42
Q

Attain bladder control

A
  • Bladder retraining program
  • Offer urinal/bedpan on schedule
  • Avoid use of catheters
  • Upright posture and standing position for males
43
Q

What medications can decrease a patients risk for stroke?

A
  • Warfarin
  • Antiplatelet
  • Statin
  • Antihypertensive

IM4 (11 decks)

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