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NURS 401 > Week 6 Stroke > Flashcards

Week 6 Stroke Flashcards

1
Q

Definition of Stroke

A

Sudden death of brain cells in localized area due to inadequate blood flow

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2
Q

What are the two types of stroke?

A

Hemorrhagic & Ischemic

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3
Q

Ischemic __ % in adults?
Thrombotic - ___ %
Embolic - ___ % (associated with ________)
Unknown source ___ %

A

Ischemic – 87% in adults
Thrombotic-55%
Embolic-20% (often associated with atrial fibrillation)
Unknown source – 25%

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4
Q

Hemorrhagic-___% in adults
Intraparenchymal (Intracerebral) hypertension - __ %
Subarachnoid space (i.e. hypertension or aneurysm rupture)- __ %

A

Hemorrhagic-13% in adults
Intraparenchymal (Intracerebral) hypertension -10%
Subarachnoid space (i.e. hypertension or aneurysm rupture)-3%

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5
Q

In perinatal stroke, what type of stroke is most common?

A

Hemorrhagic 29/100,000 live births

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6
Q

In childhood, what percentage is ischemic?

A

50%

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7
Q

Causes of childhood ischmemia?

A
  1. Sickle cell disease
  2. Congenital heart disease (R to L shunt)
  3. Cerebral arteriopathy
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8
Q

Causes of childhood hemorrhagic stroke?

A
  1. Arterio-venous malformations

2. Other congenital abnormalities

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9
Q

Stroke risks outside of hospital setting?

A
  • A-Fib
  • Cardiovascular disease
  • Cardio meds
  • Diabetes
  • Smoking
  • African American
  • Elderly
  • Past head trauma
  • Uncontrolled HTN
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10
Q

Stroke risks inside of hospital setting?

A
  • Elderly
  • Sedentary
  • DVT
  • Post op
  • Cardiovascular disease
  • A-Fib
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11
Q

What kind of headaches are at greater risk for stroke?

A

Migraine headaches (ischemic>hemorrhagic) because of vasoconstriction

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12
Q

What sleeping condition is at greater risk for stroke?

A

Sleep apnea

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13
Q

Stroke Risk Factors?

A
  1. High BP
  2. Physical inactivity
  3. Smoking/Tobacco use
  4. High blood cholesterol (diet / statins)
  5. Heart dysrhythmia (A-FIb)
  6. DM
  7. FHx Migraines
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14
Q

Life Style Modifications

A
  1. Regular monitoring of BP
  2. Healthy diet
  3. Relax/stress reduction
  4. Optimal body weight
  5. Exercise, sleep
  6. Avoid excessive alcohol/drugs
  7. Stop smoking
  8. Medication-statins, cardioembolic
  9. Monitor HR meds
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15
Q

TIA (definition / duration)

A

Temporary localized reduction of blood flow to brain

REVERSIBLE, usually less than 15 minutes but within 24 hours

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16
Q

TIA symptoms

A

Syncope / fall / loss of speech / weakness / numbness / temporary paralysis / visual impairment
Symptoms resolve without neurological dysfunction

17
Q

TIA warning sign for?

A

Stroke! 40% of those that experience TIA will eventually have a stroke

18
Q

BEFAST

A

B - balance
E- Eyes - blurry, field of vision lost
F - Face - smile, frown, even drooling
A - Arms - unequal grip, wekaness on one side
S - Speech - unable to repeat, slurs or inappropriate words
T - Time is critical
Other concerns - severe unexplained headache, seizures

19
Q

Afib increase risk factor of stroke by

A

FIVE FOLD

20
Q

Other dx other than stroke

A

Hyponatremia

21
Q

Why is CT / X-ray chosen over MRI

A

Even though image is not clear, it is a 1st screening tool. Faster / more accessible.

22
Q

What is done after CT?

A

Carotid Duplex - look for bruits

23
Q

Treatment of Ischemic Stroke

A

if CT is negative for intracranial hemorrhage then
tPA [Window 3.5-4 hours - otherwise risk rise significantly]
Carotid bruits
33% more likely to have minimal or no deficit at 3 months than those given placebo
Assess for BLEEDING post treatment 6%

24
Q

Treatment of Hemorrhagic Stroke

A

Reverse anticoagulation Vitamin K
Treatment of aneurysm (clipping, coiling, wrapping)
Surgical removal of hematoma

25
Q

Which type of hemorrhagic stroke can be reabsorbed?

A

Subarachnoid hemorrhage

26
Q

Diplopia

A

Double vision

27
Q

Hemiparesis

A

Weakness of one side of the body

28
Q

Dysarthria

A

Difficulty forming words

29
Q

Ataxia

A

Unable to keep feet together, needs broad base to stand, staggering gait

30
Q

Paresthesia

A

Numbness ,tingling, pins, difficulty with proprioception

31
Q

Dysphagia

A

Difficulty swallowing

32
Q

Hemiplegia

A

Paralysis of the face, arm, and leg on the same side of the body

NURS 401 (3 decks)

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