Stroke, COPD, MS Flashcards
What is a stroke?
Interruption of perfusion to the brain that results in infarction (brain death). Severity depends of location/extent of brain involved.
Time of neurological metabolism, metabolism, and cell death altered because of stroke?
NM- 30 seconds
M- stops in 2 minutes
CD- 5 minutes
What is a transient ischemic attack? (TIA)
Brief episode of neurological dysfunction (usually less than 1 hr). Caused by ischemia but no cell death. Includes visual/mobility/sensory/perception/speech symptoms. It is an intermittent blockage and treated as a stroke.
Symptoms of TIA?
Slurred speech (muscle paralysis of speaking), vertigo, aphasia. Symptoms will resolve.
What is an ischemic stroke and types?
Caused by a clot. 2 types are thrombotic and embolic.
What is a thrombotic stroke?
Narrowing of artery by fatty deposits of plaque. Causes a clot to form which will block entry of blood through the artery.
Embolic stroke?
Embolus is a blood clot that circulates in blood and moves. It blocks blood flow to brain. Can be caused by atrial fibrillation.
What is atrial fibrillation?
Irregular heart rhythm so blood will pool in atrium and form a clot that is released into blood stream.
What is a hemorrhagic stroke?
Bursted blood vessel allow blood to seep into and damage brain tissues until clotting shuts off the leakage. Described as the worst headache of their life. There’s 3 types (aneurysm, ateriovenous malformation (born with it, blood vessel weak and at risk for breaking open).
Risk factors for stroke?
Smoking, obesity, hypertension, diabetes, high cholesterol, family hx of atherosclerosis.
History (things we want to know for a stroke)?
Want to know time last seen normal, patients LOC, medications, hx of atrial fibrillation, have they experienced these symptoms before, any impaired cognition/mobility/sensory perception.
What do we do for health promotion for stroke?
Modify risk factors, control BP, use aspirin, smoking cessation, and manage cholesterol.
Lab/assessments for stroke?
No lab assessments confirm a stroke by APTT gives us a baseline for anticoagulation therapy. CT is a 3D image of brain that tells us type of stroke they’re having. We want to get them in CT scanner within first 60 minutes.
What does fast stand for?
F- face (is it drooping)
A- arms (can you raise both)
S- speech (is it slurred or jumbled)
T- time, call 911 right away and act fast
What is the Canadian neurological scale?
Assess LOC/orientation/speech (give commands and ask questions, they answer correctly). Motor (assess face, arms, legs). Test expression by give people items and ask patient to identify them.
Characteristics of symptoms with stroke?
Symptoms usually don’t differ between types of strokes, they are related to the location of stroke, and many body functions are affected.
Goal of stroke therapy?
Re-establish blood flow.
What is fibrinolytic therapy?
Busts the clots and its given IV. Do CT scan first the find out type of stroke. Rule out hemorrhagic stroke and this therapy is only given to ischemic stroke. Give 4.5 hrs after onset of symptoms (less effective after 4.5 hrs because damage has already occurred). Want to reverse and minimize obstruction effects.
Embolectomy?
Remove a clot by surgically pulling it out.
What is a carotid artery angioplasty/stent?
Open up the artery by putting in a balloon or stent.
What medications can you use to treat a stroke?
Anti platelet agents (aspirin or clopidogrel). Anticoagulants (prevents further episodes of stroke, more for ischemic strokes). Nimodipine administered to hemorrhagic stroke to relax blood vessel of cerebrosystem. Stool softeners/analgesics/anti-anxiety meds all reduce inter cranial pressure.
