Strokes Flashcards
How do strokes happen
Cerebral vascular access disruption, ischemia or brain hemorrhage in brain cells
Things you can do to avoid stroke
Live healthy lifestyle to AVOID
hypertension, metabolic syndrome, heart disease, heavy alcohol consumption, poor diet, drug abuse, sleep apnea, sleep apnea, obesity, physical inactivity, smoking
What are the non-modifiable risk factors of stroke
age, gender, race, hereditary/family history
whats a TIA
no actual infarction of the brain
neurologic dysfunction caused by focal brain, spinal cord, or retinaal ischemia
ischemic stroke
inadequate blood flow to brain
thrombotic, embolic strokes
thrombotic stroke
thrombosis develops where there is plaque in narrowed blood vessels. thrombotic stroke is most common cause of stroke. more common in older adults with high cholesterol, atherosclerosis, or diabetes
embolic stroke
second most common cause of stroke
most emboli originate in the inside layer of the heart (endocardial) when a plaque breaks off and enters circulation
clot lodges where vessel narrows or bifurcates (splits into two)
hemorrhagic stroke
intracerebral/intraparenchymal hemorrhage (bleeds into brain tissue itself)
subarachnoid hemorrhage (SAH) (bleeding into subarachnoid space)
intraventricular hemorrhage (bleeding into ventricles)
memorize order of meninges
scalp, skull, periosteal sura mater, meningeal dura mater, arachnoid mater, subarachnoid space, pia mater, cerebral cortex
What are the symptoms of stroke
balance
eye
face
arm
speech
time
symptoms of right side brain damage
left side paralysis
left sided neglect
spatial-perceptual deficits
pt tends to deny/minimize problems
rapid performance, short attention span
impulsive, safety problems
impaired judgement
impaired time concepts
symptoms of left side brain damage
right side paralysis
impaired speech/language
impaired right/left distinction
slow performance, cautious
hyperaware of deficits, depression/anxiety
impaired comprehension related to language/math
difference between aphasia and dysphasia
Aphasia is total loss of comprehension/use of language but is receptive and expressive
Dysphasia is difficulty related to comprehension use of language
What is dysarthria
disturbance of muscular control of speech
Includes pronunciation, articulation, phonation
What is the primary diagnostic test used to Dx a stroke
CT
noncontrast can differentiate between ischemic and hemorhagic stroke
What med is the most frequently used antiplatelet drug
aspirin
What are the initial interventions of a stroke pt
ABCs
Elevate head of bed 30 degrees
Precautions same as seizure
When would you administer BP meds to a pt stroke pt
If they don’t receive fibrolytic therapy, only if BP is SBP greater than 220 mmHg or DBP greater than 120mmHg
What is the cushings triad
increased intercranial pressure from bleed causes pressure on brain stem that ultimately causes bradycardia, irregular respirations, and increased systolic pressure same diastolic pressure aka widening pressure
What is a recombinant tissue plasminogen activator (tPA)
reestablishes blood flow through a blocked artery to prevent cell death
must be admin within 4.5 hrs of onset of clinical signs of ischemic stroke
many contraindications: major surgey in the past two weeks, recent internal bleeding in past 22 days, head trauma in past 3 months, GI bleed, coag disorders, make sure it isnt a hemorrhagic stroke
when would you use aspirin for a stroke pt
24-48 hrs after ischemic stroke episode. Anticoags and anti-platelets may be used in effort to prevent further clot forma
T/F: statin drugs can be used to treat stroke
T
What type of surgical procedures are used for some stroke treatments
evacuation of hematoma greater than 3 cm
clipping/coiling of aneurysms followed by oral nimodipine to prevent cerebral vasospasm (asses BP/HR)
endovascular procedure to open blocked arteries
how long can a pt lay on affected side
30 min
How would you assist a pt with apraxia
inability to motor plan and perform tasks/movements d/t brain damage
How to provide care to a patient with left side brain damage from stroke
slower in organization/performance of tasks
impaired spatial discrimination
fear, anxiety
responds well to verbal cues
How to provide care to a patient with right side brain damage from stroke
difficulty in judging position, distance, and movement
impulsive, impatient, and denying problems r/t stroke
respond best to directions given verbally
