stroke terms Flashcards
agnosia
failure to recognize objects ‘
atrial venous malformation
theres no organization at the circle of willis
cryptogenic stroke
no one cause, could be drugs, coagulopathies, migraines, spontaneous dissections of coratid or vertebral arteries
every hour you stroke-
the brain is aging three and a half years
pathophysiology of a ischemic stroke
disruption in blood flow, aerobic respirations, acidosis, damage to the surrounding cells
pneumbra region
area around the body that is low as cerebral blood flow
can be salvaged
if left untreated the area of damage will increase and produce free radicals
clinical manifestations of an ischemic stroke
symptoms depend on location and size
numbness or weakness of face, arm, legs, especailly on one side
confusion
trouble speaking or understanding speech
difficulty walking, dizziness, loss of balance or coordination
sudden severe head ache
perceptual disturbances
the right side of the brain is
creative
left side of the brain is
analytic
average time of recovery
18 months
with a stroke people often have motor defects
opposite side of where the stroke is
aphasia
expressive
receptive
global
behavioral symptoms of a left side stroke
rt side paralysis rt visual deficits aphasia altered intellect slow cautious behavior
behavioral symptoms right sided stroke
paralysis and weakness on left side visual deficits on left side spatial awarness defecits increased distractibility impulsive behaviors and poor judgement lack of awarness of deficits
general s/s of ischemic stroking
motor loss
communcation loss
sensory loss cognitive impairment
psychological effects
TIA
sudden neuro deficits lasting an hour, warning sign of an impending stroke
no ischemia/long term damage
stroke protocol
ct done in 25 minutes or less MRI determine if stroke is hemorrhagic or ischemic id source ekg doppler studies
prevent stroke
treat peridontal diseases
carotid endartectomy
acute phase of a stroke
tPA with in 3 hours of stroke. improved outcome
maintain airway - o2 immediatly to vaso dilate
elevate hob to decrease icp
continous hemodynamic monitoring and neurologic assessment
2 18 gauge IV
no abgs
imaging competed in 25 minutes in ear
transfer to a higher level of care
contraindications for tPa
inr >1.7, recent cva, recent head injury or trauma
managment of patient not receiving Tpa
LMWH monitor icp mannitol paco2 30-35hhmg o2, hob 25-30 degres s intubation and hemodynamic monitoring icu support surgical invention for CEA edema causes death and decreased o2 can cause brainstem herniation
CEA
better with older people
younger people do better with stenting
nursing process and care
loc, neuro assessment, mobility, joint deformities, skin integrity, pressure ulcers, self-care, nutritional and bladder/bowel, cognition, family coping, splinting to position of function, wash clothes in hangs/ alignment
prevent flexion contractures, do not lift by flaccid shoulder, measures to prevent shoulder problems, passive rom 4-5 times a day
turm head to assist eith visual deficits
EXERCISE UNAFFECTED SIDE
signs and symptoms of a hemorrhagic stroke
sudden change in loc n/v severe head ache brain stem involvement loss of consciousness nuchal rigidity visual loss diplopia tinnitus dizziness hemiparesis severe bleeding can cause damage that leads to rapid progression of symptomology which causes coma and death
complication of hemmorrhagic stroke
re bleed hematoma expansion cerebral vasospasm, ischemic event acute hydrocephalus seizures H&H, IV hydration, vasospasm, icp, uncontrolled HTN is cause of intracranial hemorrhage, stool softeners to prevent and increase BP
medical managment
control of HTN
Ct scan, cerebral angiography, care is primarily supportive, bed rest with sedation, oxygen, tx of hyperglycemia, trx of vasospasm, increased ICP, HTN, potential seizures, prevention of further bleeding, avoid stress dont be rough
korsakoffs syndrome
psychosis and delirium
potential complication of ischemic stroke
vasospasm seizures hydrocephalus rebleed hyponatermia
aneurysm precautions
absolute bed rest
elevate HOB 30 degrees
avoid all activity that may increase ICP or BP
Valsalva manuver
acute flexion of the head or neck
exhale through mouth to decrease strain
nurse provides all personal care and hygiene
non stimulating, non stressful environment
no reading, no TV, no Radio, prevent constipation
restrict vistors
interventions
relieve sensory deprivation and anxiety
keep sensory stimulation to a minimum for aneurysm precautions
patient and family education
support reassurance
seizure precautions
strategies to regain and promote self care
after the stroke
aspiration
assistive devices for ADLs
nutritional support (tube feeds or swallowing techniques)
elimination of bowel and bladder programs, catheter use
exercise activities, recreation and diversion
socailization, support groups, community resources
hemiplegia
paralysis on one side of the body
hemiparesis
slight paralysis or weakness on side of the body
dysarthria
difficulty speaking
aphasia
expressive
receptive unable to understand written or spoken language
global expressive and receptive aphasia
hemianopsia
blindness in over half the field of vision
effects of sugar on the brain
hypoglycemia: fatigue, shaking, confusion or unresponsiveness, insomnia
hyperglycemia: headache, trouble concentrating, blurred vision
