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NURS 310 - Exam 3 > Transient Ischemic Attacks / Strokes > Flashcards

Transient Ischemic Attacks / Strokes Flashcards

1
Q

What is a cerebrovascular accident?

A

Sudden loss of function due to lack of blood flow to the brain

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2
Q

What are the types of strokes? (3)

A
  • Ischemic
  • Hemorrhagic
  • Transient ischemic attack (TIA)
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3
Q

What is the most common type of stroke?

A

Ischemic

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4
Q

Describe pathophysiology of ischemic strokes (2)

A
  • Abrupt disruption of blood flow
  • Lack of oxygen / nutrients to part of the brain
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5
Q

What are the causes of ischemic strokes? (3)

A
  • Embolus
  • Thrombus
  • Hypoperfusion
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6
Q

What process takes place due to disruption of blood flow?

A

Anaerobic respiration

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7
Q

Describe the pathophysiology of an ischemic cascade (3)

A
  • Decreased efficiency of neurons
  • Decreased ATP
  • No cellular function
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8
Q

What is the penumbra region?

A

Ischemic brain tissue that may be salvaged with timely intervention

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9
Q

The penumbra region is an area of …

A

Cerebral blood flow surrounding the infarction

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10
Q

In older age, ______ are at higher risk of strokes

A

Women

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11
Q

Neurological deficits caused by strokes are dependent on what factors? (3)

A
  • The location of affected area
  • The size of affected area
  • The amount of collateral blood flow surrounding affected area
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12
Q

What is a contralateral stroke?

A

The side of the body that is functionally affected is opposite to the brain hemisphere affected by the stroke

  • Right-sided stoke - left side of the body is affected
  • Left-sided stroke - right side of the body is affected
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13
Q

What are the manifestations of an ischemic stroke? (5)

A
  • Difficulty speaking
  • Loss of coordination
  • Visual disturbances
  • Confusion
  • Weakness
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14
Q

Why is blood glucose testing used for stroke diagnosis?

A

Hypoglycemia mimics stroke - rule out

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15
Q

What is the primary diagnostic testing used for stroke diagnosis?

A

MRI

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16
Q

What is the purpose of a non-contrast CT scan of the head in stroke diagnosis?

A

Determines if the stroke is ischemic or hemorrhagic

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17
Q

What are the types of thrombolytic therapy? (2)

A
  • Tissue plasminogen activator (TPA)
  • Tenecteplace (TNK)
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18
Q

What must be determined regarding eligibility of thrombolytic therapy?

A

Last known well / last known normal time

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19
Q

Thrombolytic therapy must take place ______ after onset of symptoms

A

3 hours

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20
Q

What is endovascular therapy in the treatment of strokes?

A

Catheterization through an artery to retrieve a clot

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21
Q

Endovascular therapy is considered for EVERY patient within ______ of onset of an acute stroke

A

4.5 hours

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22
Q

Even if endovascular therapy is considered, ______ should still be administered

A

TPA

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23
Q

What is a carotid endarterectomy?

A

Surgical removal of a clot from the carotid arteries

24
Q

_______ should be placed during a carotid endarterectomy to keep the artery patent

A

Carotid stents

25
Q

______ determine the amount of stenosis in the carotid arteries (determines need for carotid endarterectomy)

A

Carotid dopplers

26
Q

A carotid endarterectomy is indicated for which types of strokes? (2)

A
  • Ischemic stroke
  • Transient Ischemic attack (TIA)
27
Q

Describe the nursing interventions associated with a carotid endarterectomy (4)

A
  • Control blood pressure
  • Cranial nerve assessment
  • Measure neck circumference
  • Neurological checks
28
Q

What medications are used for stroke treatment if a patient is not within the TPA administration window? (5)

A
  • warfarin
  • aspirin
  • clopidogrel
  • atorvastatin
  • lisinopril
29
Q

Stroke prevention begins at ______

A

Primary prevention

30
Q

______ is a temporary or intermittent neurological event that can result from any situation that reduces cerebral circulation

A

Transient ischemic attack (TIA)

31
Q

In a TIA, the patient has stroke-like symptoms, but …

A

They resolve within 24 hours without any intervention

32
Q

Patients who have a TIA are at an increased risk of ______

A

Strokes

33
Q

About 50% of patients who have a TIA have a stroke within ______

A

48 hours

34
Q

TIAs are caused by any condition that …

A

Decreases cerebral blood flow

35
Q

What is the primary goal of TIA treatment?

A

Stroke prevention - treat underlying cause

36
Q

Describe the treatment of a TIA (2)

A
  • Anticoagulants
  • Vascular reconstruction
37
Q

What is a hemorrhagic stroke?

A

Bleeding in the brain caused by intracerebral / subarachnoid hemorrhage

38
Q

Hemorrhagic stroke symptoms are produced when ______ is impaired

A

Normal brain metabolism

39
Q

What are the causes of a hemorrhagic stroke? (4)

A
  • Anticoagulants
  • Aneurysm
  • Hypertension
  • Trauma
40
Q

What are the manifestations of a hemorrhagic stroke? (4)

A
  • Severe, “thunderclap” headache
  • Loss of consciousness
  • Nausea / vomiting
  • Seizures
41
Q

Describe the nursing interventions associated with hemorrhagic strokes (6)

A
  • Bedrest
  • Control blood pressure
  • Control ICP
  • Control fever
  • Prevent aspiration
  • Prevent seizures
42
Q

Describe blood glucose goals associated with hemorrhagic stroke treatment

A

Treat hyperglycemia / prevent hypoglycemia

43
Q

During the treatment of a hemorrhagic stroke, systolic blood pressure should be kept around ______

A

140

44
Q

Describe the surgical management of hemorrhagic strokes (2)

A
  • Craniotomy
  • Craniectomy
45
Q

What is a craniotomy?

A

Opening the skull to gain access to intracranial structures (skull replaced)

46
Q

What is a craniectomy?

A

Excision of the skull to gain access to intracranial structures (skull removed)

47
Q

Describe nursing management associated with a craniotomy / craniectomy (3)

A
  • Administer mannitol
  • Neurological checks
  • Prevent seizures
48
Q

Describe nursing management specific to a craniectomy (2)

A
  • Prevent edema
  • Wear a helmet when out of bed
49
Q

The ______ quantifies the deficits of a stroke

A

NIH Stroke Scale

50
Q

______ is the primary cause of intracerebal hemorrhage

A

Uncontrolled hypertension

51
Q

Ischemic strokes with no thrombolytic therapy indicate ______

A

Permissive hypertension

52
Q

______ is often the drug of choice for hypertension during stroke treatment

A

IV labetalol

53
Q

What is the normal Glasgow Coma Scale (GCS) value?

A

15

54
Q

Stroke rehabilitation facilities use ______ care

A

Interdisciplinary - PT, OT, speech therapy

55
Q

Admission to rehab is based on ______

A

Functional independence measurement

56
Q

Stroke rehabilitation aims to restore what functions for the patient? (4)

A
  • Eating
  • Talking
  • Walking
  • Voiding

NURS 310 - Exam 3 (9 decks)

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