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Critical Care Nursing > Strokes > Flashcards

Strokes Flashcards

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1
Q

Ischemic strokes are caused by what?

A

interruption in blood flow caused by a blood clot or narrowing of the arteries

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2
Q

Ischemic Strokes are divided into what 3 categories?

A

Large-artery thrombotic stroke
Embolic Stroke
Small penetrating artery thrombotic stroke

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3
Q

What are Hemorrhagic Strokes?

A

A ruptured artery resulting is bleeding in or around the brain

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4
Q

Causes of Hemorrhagic Strokes

A
  • aneurysm bursts
  • uncontrolled HTN
  • old age
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5
Q

What happens with Ischemic Cascade?

A

The brain cells switch to anaerobic metabolism, generating large amounts of lactic acid/glautamate causing a change in pH

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6
Q

What are Large-artery Thrombotic Strokes caused by?

A

Atherosclerotic plaques in the large blood vessels of the brain

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7
Q

Thrombus formation/occlusion can occur at the site of the atherosclerosis and result in what?

A

Ischemia and Infarction

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8
Q

What is the most common type of ischemic stroke?

A

Small Penetrating Artery Thrombotic Stroke

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9
Q

Small penetrating artery thrombotic strokes are typically caused by what?

A
  • longstanding HTN
  • hyperlipidemia
  • diabetes
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10
Q

Cardiac Embolic strokes are associated w/ what?

A
  • Arrhythmias like A-fib
  • valvular heart disease
  • left ventricular thrombus
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11
Q

What are Cryptogenic Strokes?

A

Strokes w/ no identifiable cause

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12
Q

Strokes from Other Causes

A

drugs (cocaine)
coagulopathies
migraine
spontaneous dissection

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13
Q

Risk Factors for Stroke (STROKES HAPPEN)

A 
S-smoking
T-thinners
R-rhythms
O-oral contraceptives
K-kin/family 
E-excessive weight
S-senior citizens
H-HTN
A-atherosclerosis
P-physical inactivity
P-previous TIA
E-elevated glucose (diabetes)
N-aNeurysm
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14
Q

What is a TIA?

A

“Mini Stroke”

a brief episode of neurologic dysfunction

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15
Q

TIA are results from what?

A

Focal cerebral ischemia, but NOT associated w/ permanent cerebral infarction

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16
Q

What are the 2 subtypes of Hemorrhagic Strokes?

A

Intracerebral and subarachnoid

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17
Q

How long does a nurse have to administer TPA to help break up the clot and resolve the stroke?

A

3 hours from the time the S/S start

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18
Q

S/S of Strokes (FAST)

A 
F-face-drooping/asymmetric 
A-arms-numb or weak 
S-speech-slurred
T-time to act 
-aphasia
-dysarthria 
-apraxia 
-agraphia 
-alexia 
-agnosia
-dysphagia 
-hemianopia
19
Q

Aphasia

A

unable to speak or comprehend speech

-receptive and expressive

20
Q

Receptive Aphasia

A

unable to comprehend speech

Werincke’s Area

21
Q

Expressive Aphasia

A

comprehends speech but can’t respond back w/ speech

Broca’s Area

22
Q

Intracerebral Hemorrhage are commonly results of what?

A

Trauma

23
Q

Dysarthria

A

unable to speak clearly due to weak muscles

24
Q

Apraxia

A

can’t perform voluntary movements

25
Q

Agraphia

A

loss ability to write

26
Q

Alexia

A

loss ability to read-cannot understand or see words

27
Q

Subarachnoid Hemorrhage is commonly associated w/ what?

A

intracranial aneurysms
trauma
arteriovenous malformations

28
Q

Agnosia

A

doesn’t understand sensations or recognize known objects/people

29
Q

Dysphagia

A

issues swallowing

30
Q

Hemianopia

A

limited vision

31
Q

Primary ICH from spontaneous rupture of small arteries is commonly caused by what?

A

Uncontrolled HTN

32
Q

How are Strokes diagnose?

A

CT scan

MRI

33
Q

TPA (Altepase) is used only for what type of stroke?

A

Ischemic Strokes

34
Q

How does TPA work?

A

dissolves the clot by activating the protein that causes fibrinolysis

35
Q

Criteria for Receiving TPA (Altepase)

A
  • CT scan negative for bleeding
  • Labs w/ normal limits
  • BP controlled < 185/110
  • Hasn’t recently received Heparin or other anticoagulants
36
Q

Nursing Interventions for TPA (Altepase)

A
  • monitor for bleeding
  • Neuro checks around the clock
  • BP meds if needed for HTN
  • vital signs/labs
  • bedrest
  • avoid sticks and IM injections
  • ICU to be monitored
37
Q

Patients w/ ruptured AVM will typically present w/ what?

A

sudden severe headache and sudden LOC

38
Q

What is the most common motor dysfunction resulting from stroke?

A

Hemiparesis-weakness on one side of body

39
Q

What is the most common visual impairment after stroke?

A

Hemianopia-visual field loss

40
Q

Dysphagia can lead to what types of problems?

A

aspiration pneumonia
dehydration
poor nutrition

41
Q

Optimal Medical Therapy for prevention of more strokes includes prescribing what Meds?

A
  • anti-platelet
  • a statin
  • antihypertensive
  • anticoagulant
42
Q

Carotid Endarterectomy (CEA)

A

removal of atherosclerotic plaque or thrombus from the ICA to prevent recurrent stroke

43
Q

What is an alternative to a CEA when surgery poses a high risk?

A

Carotid Angioplasty and stenting

44
Q

When are CEA’s or Carotid Angioplasty’s recommended?

A

When the patient is hemodynamically stable and w/in 2 weeks following event

Critical Care Nursing (14 decks)

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