Stroke (Brain Attack)

Question 1

What is a Transient Ischemic Attack (TIA)?

Answer 1

A brief stroke-like attack that, despite resolving within minutes to hours, still requires immediate medical attention to distinguish from an actual stroke.

Question 2

How long does a TIA last?

Answer 2

minutes to

Question 3

What is Reversible Ischemic Neurologic Deficit (RIND)?

Answer 3

A small stroke that the patient was able to fully recover from within a few weeks.

Question 4

How long does RIND last?

Answer 4

> 24 hours but

Question 5

___ and ___ are warning signs of a stroke and is caused by a brief interruption in ____ blood flow.

Answer 5

TIA, RIND

Cerebral

Question 6

Treatment of TIA and RIND include

Answer 6

Complete neuro assessment, CT scan, lab, ECG, possible admission and anticoagulant therapy (clopidogrel)

Question 7

What is a brain attack?

Answer 7

A stroke

Question 8

A stroke is the change in normal ___ ___ to the brain.

Answer 8

Blood supply

Question 9

What 2 things supplies the brain for normal functioning?

Answer 9

Glucose and oxygen

Question 10

Blood flow in the brain is important for the removal of ____ ____

Answer 10

Metabolic waste (carbon dioxide, lactic acid)

Question 11

What are the 2 causative agents of a stroke

Answer 11

Hypertension and arteriovenous malformation (An abnormal connection between arteries and veins, usually in the brain or spine.)

Question 12

Types of strokes

Answer 12

Ischemic (thrombolic, embolic) and hemorrhagic

Question 13

Onset of a thrombotic, embolic and hemorrhagic stroke

Answer 13

gradual, sudden, sudden

Question 14

Ishemic strokes are cause by

Answer 14

thrombus (hypertension or atherosclerosis/The build-up of fats, cholesterol, and other substances in and on the artery walls.) or embolus (cardiac diseases)

Question 15

Hemorrhagic strokes are caused by

Answer 15

Aneurysms (abnormal balloning or blister along a normal artery) or hypertension. These are caused by hypertension or vessel diseases.

Question 16

An uncommon abnormality that occurs during embryonic development. A tangled collection of malformed thin walled dilated vessels without capillary network. (these may rupture and cause bleeding into the intracerebral tissues or spaces.)

Answer 16

Arteriovenous Malformation (AVM)

Question 17

What are some risk factors for strokes?

Answer 17

Smoking
Substance abuse
Obesity
Sedentary lifestyle (no or irregular physical activity)
Oral contraceptive use
Heavy alcohol use
Use of phenylpropanolamine (PPA/no longer produced in the US)

Question 18

The highest stroke death rate are where?

Answer 18

The south

Question 19

Early intervention: How to spot a stroke (warning signs and symptoms)

Answer 19

F.A.S.T.
Face drooping
Arm weakness
Speech difficulty
Time to cal 911

Question 20

Neurological assessment of a stroke patient

Answer 20

NIH Stroke Scale (0-40)
Cognitive changes (denial of illness, awareness of body position in space dysfunction, impaired memory/judgement/problem solving/decision making, deceased ability to concentrate and attend to tasks)
Visual changes
Facial palsy
Motor changes (ataxia, hypotonia, hypertonia, agnosia, apraxia)
Sensory changes (unilateral body neglect syndrome, ptosis, nystagmus, blindness)
Cranial Nerve assessment (V chew, IX swallow, gag relflex, X swallow, Vll facial parslysis or paresis, XII tongue movement )
CV assessment (heart murmurs, dysrhythmias (A-fib), hypertension)

Question 21

Problems assoicated with the Left Hemisphere of the brain

Answer 21

Aphasia/affects ability to commuinate, alexia/inability to see words or read, dyslexia/difficulty reading
Acalculia/loss of the ability to perform simple arithmetic calculations
Right visual field deficit
Anxiety, anger, frustration
Intellectual impairment

Question 22

Problems associated with the Right Hemisphere of the brain

Answer 22

Disorientation
Loss of depth perception
Unilateral body neglect syndrome
Denial of illness
impulsiveness

Question 23

Thrombolytic therapy is given __ and what drug is given

Answer 23

IV

Recombinant tissue plasminogen activator (rtPA) or Retavase

Question 24

What are the eligibility criteria for thrombolytic therapy

Answer 24

Last seen normal less than 3 hours can extend to 4.5 hours (

Question 25

What is the stroke protocol?

Answer 25

ED door to treatment

Question 26

What are endovascular interventions

Answer 26

Embolectomy- mechanical clot removal

Intra-arterial thrombolysis- can be done if within 6 hrs last seen normal

Question 27

Drug therapy to treat strokes

Answer 27

Thromboltics, anticoagulants (ASA, clopidogrel), lorazepam other AEDs, CCB, stool softeners, analgesics, antianxiety (The Angry Lady Cursed Spit And Argued)

Question 28

Surgical management of a stroke include

Answer 28

Carotid artery angioplasty with stenting
Endarterectomy
Extracranial-intracranial bypass

Question 29

Nursing interventions for a stroke patient

Answer 29

Nuero assessments (post thrombolytic and NIH guideline)
Monitor ICP
Safety (unilateral neglect)
Emotional support
Eduaction