Stroke Reading

Question 1

Either thrombotic or embolic
Most common stroke
Occlusive
Occlusion of cerebral/carotid artery by thrombus/embolus
Thrombotic
Embolic

Answer 1

Ischemic

Question 2

Associated with development atherolscerolsis
Evolution
Onset
LOC
Contributing factors
Prodromal symptom
Neurologic deficits
CSF
Seizures
Duration

Answer 2

Thrombotic

Question 3

Intermittent or stepwise improvement between episodes of worsening symptoms
Completed stroke

Answer 3

Evolution - Thrombotic

Question 4

Gradual (mins-hrs)

Answer 4

Onset - Thrombotic

Question 5

Preserved (pt is awake)

Answer 5

LOC - Thrombotic

Question 6

HTN
Atherosclerosis

Answer 6

Contributing factors - Thrombotic

Question 7

TIA

Answer 7

Prodromal symptom - Thrombotic

Question 8

May be deficits during first few weeks
Slight headache
Speech deficits
Visual probs
confusion

Answer 8

Neurologic deficits - Thrombotic

Question 9

Norm; possible presence of protein

Answer 9

CSF - Thrombotic

Question 10

No

Answer 10

Seizures - Thrombotic

Question 11

Improvements over weeks to months
Permanent deficits possible

Answer 11

Duration - Thrombotic

Question 12

Thrombus or group of thrombi break off from one area and travel to another area
Sudden development and rapid occurrence of neurologic deficits
Symptom resolve over few days
Evolution
Onset
LOC
Contributing factors
Prodromal symptom
Neurologic deficits
CSF
Seizures
Duration

Answer 12

Embolic

Question 13

Abrupt development of completed stroke
Steady progression

Answer 13

Evolution - Embolic

Question 14

Sudden

Answer 14

Onset - Embolic

Question 15

Preserved (pt is awake)

Answer 15

LOC - Embolic

Question 16

Cardiac disease

Answer 16

Contributing factors - Embolic

Question 17

TIA

Answer 17

Prodromal symptom - Embolic

Question 18

Max deficit at onset
Paralysis
Expressive aphasia

Answer 18

Neurologic deficits - Embolic

Question 19

Normal

Answer 19

CSF - Embolic

Question 20

No

Answer 20

Seizures - Embolic

Question 21

Usually rapid improvements

Answer 21

Duration - Embolic

Question 22

Vessel integrity interrupted and bleeding occurs into brain or subarachnoid space
Subarachnoid hemorrhage more common
Evolution
Onset
LOC
Contributing factors
Prodromal symptom
Neurologic deficits
CSF
Seizures
Duration

Answer 22

Hemorrhagic

Question 23

Usually abrupt onset

Answer 23

Evolution - Hemorrhagic

Question 24

Sudden; may be gradual if caused by HTN

Answer 24

Onset - Hemorrhagic

Question 25

Deepening lethargy/stupor or coma

Answer 25

LOC - Hemorrhagic

Question 26

HTN Vessel disorders Genetic factors

Answer 26

Contributing factors - Hemorrhagic

Question 27

Headache

Answer 27

Prodromal symptom - Hemorrhagic

Question 28

Focal deficits Severe, frequent

Answer 28

Neurologic deficits - Hemorrhagic

Question 29

Bloody

Answer 29

CSF - Hemorrhagic

Question 30

Usually

Answer 30

Seizures - Hemorrhagic

Question 31

Variable Permanent neurologic deficits possible

Answer 31

Duration - Hemorrhagic

Question 32

Prevent stroke via: Lifestyle changes, heart-healthy diet, regular activity, modify risk factors imp

Answer 32

Health promotion and maintenance

Question 33

Aspirin when appropriate BP control Cholesterol management Smoking cessation

Answer 33

Prevent stroke via:

Question 34

Transport to stroke center - priority Focused hx - determine recent bleeding even or taking anticoag Observe LOC, impaired cognition, mobility, sensory perception Question about presence sensory deficits or motor changes, visual probs, probs with balance or gait, communication probs, changes reading/writing abilities Fam hx

Answer 34

Hx

Question 35

First responders perform initial neuro exam Nurses - on arrival to ED - complete neuro assessment; commonly use NIHSS Transitioned to other areas imp assess LOC - use GCS to monitor for changes Can cause impaired airway - inadequate cough and dysphagia leading to aspiration/death 5 common symp stroke Specific symp depend on extent and location ischemia and arteries Stroke involving righ cerebral hemisphere - often experiences unaware deficits and disoriented to time and place; personality changes Left cerebral hemisphere - affects speech, language, math skills, analytic thinking Embolic strokes - heart murmur, dysrhythmias, and/or HTN - Need to maintain cerebral perfusion so cannot have BP above 150/100

Answer 35

Phys assessment/s&s

Question 36

Sudden confusion/trouble speaking/understanding others Sudden numbness/weakness of face, arm, leg Sudden trouble seeing in 1/both eyes Sudden dizziness, trouble walking, or loss of balance or coordination Sudden severe headache with no known cause

Answer 36

5 common symp stroke

Question 37

Expressive Receptive Mixed Global

Answer 37

Types of aphasia

Question 38

Referred to as Broca/motor aphasia Difficulty speaking and writing

Answer 38

Expressive - Types of aphasia

Question 39

Referred to as Wernicke/sensory aphasia Difficulty understanding spoken words/written words Speech often meaningless Made-up words

Answer 39

Receptive - Types of aphasia

Question 40

Combo difficulty understanding words and speech Difficulty with reading and writing

Answer 40

Mixed - Types of aphasia

Question 41

Profound speech and language probs Often no speech or sounds that cannot be understand

Answer 41

Global - Types of aphasia