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409 3 Flashcards

1
Q

Offers the worst prognosis if occluded

A

Basilar Artery

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2
Q

Patients with ___ and ____ frequently present with small ischemic stroke syndromes (Lacunar stroke)

A

diabetes and hypertension

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3
Q

Patients with Middle Cerebral Artery stroke are at risk for

A

seizures and herniation

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4
Q

50% of trombotic stroke patient have

A

TIAs

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5
Q

When does thrombotic stroke normally happen

A

night

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6
Q

Most catastrophic type of stroke

A

HEMORRHAGIC

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7
Q

Hemorrhage Symptoms: ____ intolerance

A

light

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8
Q

Hemorrhage Symptoms: ___ pain

A

neck

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9
Q

the single most important determinant of treatment options during the hyperacute phase.

A

when the stroke started

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10
Q

IS RARELY NECESSARY WITHIN THE FIRST MINUTES FOLLOWING A STROKE

A

INTUBATION

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11
Q

Impulsive or unorganized in Activities of Daily Living

A

LEFT HEMIPLEGIA (RIGHT SIDED HEMISPHERE)

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12
Q

Lack insight into these problems

A

LEFT HEMIPLEGIA (RIGHT HEMISPHERE)

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13
Q

Limits or eliminate words

A

RIGHT HEMIPLEGIA (LEFT HEMISPHERE)

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14
Q

Vocabulary and auditory span reduced

A

RIGHT HEMIPLEGIA (LEFT HEMISPHERE)

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15
Q

Left or Right problem? Left gaze preference

A

Left

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16
Q

Left or Right problem? Right visual field deficit

A

Left

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17
Q

Left or Right problem? Right hemiparesis

A

Left

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18
Q

Left or Right problem? Right hemisensory loss

A

Left

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19
Q

Left or Right problem? Right gaze preference

A

Right

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20
Q

Left or Right problem? Left visual field deficit

A

Right

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21
Q

Left or Right problem? Left hemiparesis

A

Right

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22
Q

Left or Right problem? Left hemisensory loss neglect (left hemi-inattention)

A

Right

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23
Q

Stroke: VOMITING SHOULD BE TREATED WITH

A

ANTIEMETICS AND NGT

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24
Q

WHEN STROKE OCCURS, AN ELEVATED BLOOD PRESSURE is always REDUCED IF THE STROKE IS

A

HEMORRHAGIC

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25
IF ISCHEMIC, ELEVATIONS IN BLOOD PRESSURE SHOULD NOT BE IMMEDIATELY TREATED UNLESS: SYSTOLIC BLOOD PRESSURE EXCEEDS
220
26
IF ISCHEMIC, ELEVATIONS IN BLOOD PRESSURE SHOULD NOT BE IMMEDIATELY TREATED UNLESS: you have identified ____ ischemia, __, or ____ ____
CARDIAC ISCHEMIA, HF, AORTIC DISSECTION
27
IF ISCHEMIC, ELEVATIONS IN BLOOD PRESSURE SHOULD NOT BE IMMEDIATELY TREATED UNLESS: DIASTOLIC BLOOD PRESSURE EXCEEDS
110 ON REPEATED MEASUREMENTS MADE OVER 30 TO 60 MINUTES
28
IF ISCHEMIC, ELEVATIONS IN BLOOD PRESSURE SHOULD NOT BE IMMEDIATELY TREATED UNLESS: _____ THERAPY WILL BE USED
THROMBOLYTIC
29
In the 1st few hours after the stroke, BP
declines on its own
30
Stoke: CT SCAN IS CRUCIAL AS IT ALLOWS FOR ACCURATE EXCLUSION OF
HEMORRHAGIC STROKE
31
Thrombolytic Tx: Rt-PA is packaged as a crystalline powder and is reconstituted with
sterile water
32
Thrombolytic Tx: Rt-PA: Dosing:
Give a 10% bolus over 1 minute | Give the rest (90%) over 1 hour
33
Thrombolytic Tx: Rt-PA: Dosing: Max dose for any patient is
90mg
34
Thrombolytic Tx: Rt-PA: To prevent accidental overdose, it is important to
waste amount with another nurse before administering to patient.
35
Thrombolytic Tx: Rt-PA: Prior to administering rt-PA make sure all
invasive lines are in place (e.g., endotracheal and indwelling urinary catheter)
36
Criterion for thrombolytic tx: ct scan to rule out
hemorrhage
37
Thrombolytic Tx: must start within
3 hours
38
Do you give thrombolytic tx if neuro deficit starts to improve
no
39
Thrombolytic Tx contraindicated if patient is taking anti____
anticoagulants
40
Thrombolytic Tx contraindicated if PT is
greater than 15 seconds
41
Thrombolytic Tx contraindicated if platelet count is
less than 100,000
42
Thrombolytic Tx contraindicated if BP
is over 180/110
43
Thrombolytic Tx contraindicated if there's a h/o
stroke or head trauma in the past 3 months
44
Thrombolytic Tx contraindicated if patient had major
surgery in the past 2 weeks
45
Thrombolytic Tx contraindicated if patient had GI or GU
bleed in the past 2 weeks
46
Thrombolytic Tx contraindicated if at the onset of the stroke
patient had a seizure
47
Stroke tx: No oral feeding for
24 hours
48
Stroke: fatal secondary complication
P.E.
49
Stroke: complication that happens 10% of the time
pneumonia
50
Stroke recovery: what do you do with the limbs
support with pillows
51
Patients treated with Thrombolytics: Call physician if systolic is
greater than 180 or less than 110
52
Patients treated with Thrombolytics: Call physician if Diastolic is
greater than 100 or less than 60
53
Patients not treated with thrombolytics: Call physician if Diastolic is
greater than 120 or less than 60
54
Patients not treated with thrombolytics: Call physician if systolic is
greater than 220 or less than 110
55
Patients treated with thrombolytics: what should you know about antithrombotics
No heparin etc for 24 hours
56
Patients NOT treated with thrombolytics: what should you know about antithrombotics
they are indicated within the 1st 24 hours
57
Stroke tx: use NC to maintain saturation at
greater than 92%
58
You can't have thrombolytics if systolic is
greater than 220
59
You can't have thrombolytics if Diastolic is
greater than 120
60
3 good meds for a stroke patient with high BP is
lol, nicardinpine, nitropruss
61
Stroke: Cerebral autoregulation is lost, therefore the patient is at risk for
hypertension
62
Stroke: Most common cause of deterioration and early death
Cerebral Edema
63
2 Late signs of ICP
pupillary change | wider pulse pressure
64
Transient Cerebral Ischemia definition
brain ischemia caused by stenosis; it goes away in 24 hours
65
Ask visitors to stand on the stroke patient's ___ side
affected

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