Stroke Barry Flashcards
Stroke risk factors general
- Hypertension
- Obesity
- Substance abuse
- Atrial fibrillation
- Older adult age
- Diabetes
- History of MI or stroke
- High cholesterol levels
risk factors stroke for Barry
- Arteriosclerosis
- Hyperglycemia
- Advanced age
- Hyperension
- Type 2 diabetes
- Previous stroke
- Male sex
Stroke S+S general
F – Face = any asymmetry, face droop? = muscular control affected
A – arms = even strength? Any difficulty
S – speech = slurred speech, difficulty speaking, problems understanding you
T – time = time the person was right before stroke
Barry stoke S+S
- Difficulty walking
- Difficulty hearing
- Collapse
- Slurred speech
- Facial droop
- Difficulty moving his arm
Barry Ischemic stroke patho/effects
- Multiple emboli = likely due to rupture of an atherosclerotic plaque
= blockage in cerebral arteries
= ischemia and hypoxia
= inflammation and neuronal necrosis
Specific to barry
- Blockage occurred in left posterior cerebral hemisphere (partial, temporal and occipital lobe)
- Blockage in Bilateral cerebellum
- Blockage in Brainstem (CN 5,6,7 and 10)
= Barry patho effects
- Right hemiparesis
- Right side sensorial loss
- Right side homonymous hemianopia (both eyes he couldn’t see right side)
- Decrease visual motor coordination
evaluations
- GCS
- Scans
- Neurological exam
GCS range/Barry range/what it is
- Evaluates level of consciousness
- Normal range 3-15 (3 being dead)
- Barry 10/15 on admission later 13/15
GCS categories
- Verbal response = patient’s ability to understand language/communicate – 1 none, 5 conversant with correct response
- Eye opening = tests brain activating centers – 1 none, 4 spontaneous
- Motor response = determine ability to obey commands and assess abnormal body positions responding to pressure stimuli – 1 none, 6 normal, obeys command
Management
- medications
- rehabilitation service
treatment for ischemic stroke!!
- rtPA medication within few hours
- Anti-coagulation
How rtPA works/what it is
- Treats acute ischemic stroke only
- Goal is reperfusion of cerebral vessels
- tPA converts plasminogen into plasmin
Types of anti-coagulation/action
- Aspirin – blocks prostaglandin synthetase action
- Warfarin – inhibits vitamin K-epoxide reductase
Medications barry left with
- Paracetamol
- Aspirin
- Omeprazole – (proton pump inhibitor for gastroesophageal reflux)
-Cilazapril
Barry management plan
- Medications
- Speech language therapy – for his dysarthria and dysphagia
- Physical therapy – help with hemiparesis and truncal ataxia
- Home care
Compare ischemic stroke and hemorrhagic stroke
Ischemic = due to loss of blood supply to area of brain (blood clot)
Hemorrhagic = due to bleeding in brain by rupture of blood vessels
