Stroke Flashcards
sudden onset of focal neurologic deficit caused by disruption in the blood supply to the brain lasting >24 hours
stroke, CVA, brain attack
sudden onset of focal neurologic deficit caused by disruption in the blood supply to the brain lasting
TIA
cause of ischemic stroke
thrombosis or embolis
cause of hemorrhagic stroke
subarachnoid or intracerebral bleeds
people with these 2 things are at high risk for embolic stroke
chronic a-fib
prosthetic heart valves
people with these disorders are at high risk for thrombolic stroke
atherosclerosis, DM, HTN
sxs of stroke
numbness of face, arm or leg
trouble seeing
confusion, trouble speaking or understanding
trouble with walking, dizziness, loss of balance or coordination
sudden severe HA
acute management goals for stroke pt
maintain life
prevent further brain damage
reduce disabilities
maximum time after onset of sxs that tPA can be given
3 hours
must have a score of what on the stroke scale to get tPA
> 22
you can see this type of stroke on a CT initially
hemorrhagic
tPA cannot be given for these reasons
taking coumadin surgical procedure within last 14 days aneurysm neoplasm head injury/surgery in last 3 mo. GI/GU bleeding
blood glucose must be above what to given tPA and why
50 or above because hypoglycemia can mimic signs of stroke
following a stroke, pts will be given these meds
antiHTN heparin/coumadin antiplatelet dilantin (reduce seizure) decadron nimodipine
prior to giving tPA you must make sure all what have been completed
invasive procedures
these factors increase the risk of hemorrhagic stroke
HTN
alcohol/drug use
anticoagulants
blood clotting disorders
sxs of subarachnoid hemorrhage
usually none but some may be: "worst HA of my life" V/N photophobia stiff neck loss of consciousness
cause of ischemic stroke
thrombosis or embolis
cause of hemorrhagic stroke
subarachnoid or intracerebral bleeds
people with these 2 things are at high risk for embolic stroke
chronic a-fib
prosthetic heart valves
people with these disorders are at high risk for thrombolic stroke
atherosclerosis, DM, HTN
sxs of stroke
numbness of face, arm or leg
trouble seeing
confusion, trouble speaking or understanding
trouble with walking, dizziness, loss of balance or coordination
sudden severe HA
acute management goals for stroke pt
maintain life
prevent further brain damage
reduce disabilities
maximum time after onset of sxs that tPA can be given
3 hours
must have a score of what on the stroke scale to get tPA
> 22
you can see this type of stroke on a CT initially
hemorrhagic
tPA cannot be given for these reasons
taking coumadin surgical procedure within last 14 days aneurysm neoplasm head injury/surgery in last 3 mo. GI/GU bleeding
blood glucose must be above what to given tPA and why
50 or above because hypoglycemia can mimic signs of stroke
sudden onset of focal neurologic deficit caused by disruption in the blood supply to the brain lasting >24 hours
stroke, CVA, brain attack
following a stroke, pts will be given these meds
antiHTN heparin/coumadin antiplatelet dilantin (reduce seizure) decadron nimodipine
prior to giving tPA you must make sure all what have been completed
invasive procedures
these factors increase the risk of hemorrhagic stroke
HTN
alcohol/drug use
anticoagulants
blood clotting disorders
sxs of intracerebral hemorrhage
partial or total loss of consciousness
N/V
unilateral weakness or numbness in arm, leg, face
severe HA
sxs of subarachnoid hemorrhage
usually none but some may be: "worst HA of my life" V/N photophobia stiff neck loss of consciousness
bedrest/quiet atmosphere HOB 15-30 degrees constant assessment of BP avoid ICP stressors monitor fluids
nursing management for increased ICP
optimal BP for increased ICP
140/80, maintains perfusion
ICP stressors
sneezing, suctioning, straining, vagal stim
in a TIA there is a rapid onset of what
extremity weakness/numbness
aphasia/dysarthria
visual field blindness/diplopia
if a carotid artery is occluded this much it should be treated
49%
medical tx of a carotid occlusion
antiHTN
antiplatelet
anticoagulant
aphasia slow cautious behavior task anxiety quick anger speech and language issues memory impairment
left hemisphere brain attack
impaired humor disoriented x3 memory impairment loss of depth perception impulsive behavior poor judgment
right hemisphere brain attack
signs of dysphagia
coughing or choking gagging difficulty swallowing drooling wt loss change in dietary habits recurrent pneumonia slurred speech
