U2: Stroke Flashcards
What are the two causes of stroke?
Ischemia (blockage) and hemorrhage
Which is more common: ischemic or hemorrhagic stroke?
Ischemic strokes account for 80% of strokes.
What are the two types of ischemic strokes?
Embolic and thrombotic
What is the cause of embolic ischemic stroke?
A blood clot due to A-Fib. Clot forms in atrium due to pooling caused by decreased cardiac output.
What is the cause of thrombotic ischemic stroke?
A stationary clot in the vessel due to plaque build-up - atherosclerosis.
What is the cause of hemorrhagic stroke?
Uncontrolled hypertension or aneurysm.
What is at risk of rising with a hemorrhagic stroke?
ICP - Intracranial Pressure
Pts with hemorrhagic stroke should not be sat up over __ degrees.
30 degrees, due to risk for increased ICP
Stroke patients should be turned how often?
Every 30 minutes!
What is a TIA?
Transient Ischemic Attack. Tiny lack of oxygen for tiny amount of time. Sometimes called a ‘mini stroke.’
How long does a TIA last?
Usually less than 30 minutes
What can cause a TIA?
During or after exertion due to contraction of vessels, leads to decreased O2.
Why does HTN put pt at risk for stroke?
Systolic above 140 pounds blood vessels, which are made thinner by pressure
What is the first course of action when a suspected stroke comes into the hospital?
Get CT scan ASAP to locate stroke. Potentially start clot buster meds if within window. Aspirin, then thrombectomy
What is the window of opportunity for clot-buster medication?
4.5 hours after onset of stroke symptoms
Medications known as ‘clot busters’ are called _____.
Fibrinolytics
What is TPA?
Family of clot-buster drugs: Tissue plasminogen activator (tPA). Includes alteplase (activase), reteplase and tenecteplase
Is heparin a clot buster?
No, it is a blood thinner, thins the blood in front of the clot
How should BP be treated after stroke, and why?
For 24-48 hours, keep SBP around 170
Important not to drop too fast into hypotension, as well as maintain certain range to maximize perfusion
If a patient has a stroke on the left side of their brain, the ____ side of their body will be affected.
Right, and vice versa.
Time is ____.
Muscle!
You should place items on a stroke patient’s (affected / unaffected) side.
Affected. Pts will avoid using affected side, and it is important to retain coordination.
Strokes in the (right/left) cerebral hemisphere affect visual and spatial awareness and proprioception, sense of body perception
Right
Strokes in the (right/left) cerebral hemisphere affect skills such as speech, language, math & analytics
Left
Strokes on the _____ side of the brain can make patients unaware of deficits as well as time and space. They often have poor judgement and are impulsive.
Right. “Horse blinders impairment.”
Which races are more prone to strokes?
African American, Alaskan, Hispanic, and Asian
Which conditions increase risk of stroke?
A-fib, clotting disorders, cerebral aneurysm and hx of CVA.
What are modifiable risk factors for stroke?
Smoking, obesity, HTN, diabetes, elevated cholesterol, alcohol use, sedentary lifestyle, drugs and birth control paired with smoking, HTN and /or blood thinners.
What types of precautions should always be implemented with stroke patients?
Seizure precautions, swallow precautions
_______ _______ - Pt is unable to recognize one side of body
unilateral neglect
Paralyzed limbs must have position changed how often?
Every 30 minutes
