Stroke

Question 1

what is a stroke ?

Answer 1

typically a blood clot, aneurysm that cuts oxygen to the brain

Question 2

whats a tia?

Answer 2

transient - small time
ishemic - lack of oyxgen
attack - sudden attack

a mini stroke that happens really fast that causes the brain to not receive oxygen for a brief moment

Question 3

what are the two types of stroke ?

Answer 3

ischemic stroke ( thrombolytic )
hemorrhagic ( bleeding )

Question 4

hemorrhagic strokes is bleeding the brain and can place the patient at a high risk for what symptom?

Answer 4

increased intracranial pressure

Question 5

whats the number one risk factor for stroke ?

how do we prevent this?

Answer 5

hypertension

antihypertensive medications regulary

Question 6

why is hypertension a big risk factor for a stroke?

Answer 6

think of the patho, the blood pressure is so so intense,its constricting and could even pop

Question 7

what are the intial signs and symptoms that we will see in a patient who is having a stroke ?
think of the anagram that we use in the hospital thats posted literally everywhere!
FAST!

Answer 7

facial dropping
arm weakness
speech difficultuies
time !

Question 8

for hemorrhagic stroke, whats the key sign ?

Answer 8

severe headache, onsent of vomiting without nausea, diplopia
( silent killer )

Question 9

remember left side of the brain affects the right side of the body !

remember right side of the brain affects the left side of the body!

Question 10

left brain controls the 2L’s, which are ?

Answer 10

language and logic!

Question 11

so if there is a left brain injury, we are going to have what see ? (3 major things )

lastly, there is another thing according to the nclex book, what is something these patietns end up experiecing?

Answer 11

language ( dyspheasia, reading or writing problems )

logic ( slow performance )

right hemiparesis ( right weakness)

• aware of deficits, they know whats wrong with them, so they become depressed and anxious

Question 12

right sided brain stroke, think of the 2’rs, which are?

Answer 12

reckless and really creative

Question 13

so right sided brain stroke, we have the reckless and really creative, what else will this patient experience? (2)

Answer 13

left sided hemiparesis
visual & spatial deficts

reckless
- lack of impulse contorl
- behavior changes
( impaired judgmenet, rapid performance, short attention spam, tendys to deny problems )

Question 14

what are we going to use to diagnosis stroke?

Answer 14

ct scan

Question 15

thrombolytic stroke, what do we give for treatment?

what is the criteria before we give this medication?

Answer 15

tpa, within 4.5 hours of onset of symptoms

Question 16

what do we use to treat hemorrhagic stroke?
two major precautions that we are implemting here

Answer 16

seizure precautions
strict bed rest

Question 17

we understand that we are not going to give tpa in a hemorhaggic stroke because they will more than likely just bleed to death, so what else are we not going to give them ?

Answer 17

blood thinners
( no asprin, clopidogrel, heparin, warfarin, thrombolytics )

Question 18

lastly a patient is having a hemorrhagic stroke and our biggest risk factor is that they develop increased intracrnial pressure as the brain fills up with blood, what are some things we tell patients to not do so we avoid that increased in pressure?

Answer 18

no coughing
no sneezing
no straining
no blowing nose
no shivering

Question 19

no matter the type of stroke, patients are going to experience hemianopsia ( that blindness to sides ), so we want to eduate on what?
- dressing?
- vision?

Answer 19

dress weaker side first

scan surroundings
approach on good side

Question 20

whats the first thing we must do to help patietns who have a stroke eat?

Answer 20

we want to do get a swallow screen done so we avoid the risk of aspiration, remember its a one sided weakness, so one side of the throat wil be weak

Question 21

when a patient is eating and has had a stoke, what are we going to teach?

Answer 21

flex neck to the chin while swallowing

Question 22

what type of diet are these patietns on?

Answer 22

puree diet ( soft and liquid )

Question 23

when they are drinking fluids, what do we have to do ?

Answer 23

thicken the fluids

Question 24

how do we prevent sensory overload for a patient with stroke?

Answer 24

cluster care in one visit
morning vitals and feedings in one go

Question 25

very tricky exam questions
do we need to speak loud ?
do we complete tasks for them?
what type of questions?

Answer 25

nope!
no!
yes and no questions

Question 26

dysphasia means?
aphasia means?
ataxia means?

Answer 26

difficulty speech
without speech
difficulty walking

Question 27

whats broca aphasia ?
whats werenike aphasia?

Answer 27

expressive
- they understand but cant talk
- speech limited

receptive
- they can talk but cant understand
- weak understanding/comprehension
- misunderstanding to verbal cues
- unable to comprehend speech