Chapter 45

Question 1

Two types of strokes?

Answer 1

ischemic and hemorrhagic

Question 2

Couse of Intercerebral stroke?

Answer 2

severe hypertension, could be caused by cocaine use

Question 3

Common origin of an embolus from an embolic stroke?

Answer 3

the heart, commonly found with patients who have A fib

Question 4

What is Homonymous Hemiopsia?

Answer 4

field cut in vision, approach from unaffected side and remind them to scan their environment

Question 5

What is an aneurysm?

Answer 5

blister along artery

Question 6

What is an Anterio-venous infarction?

Answer 6

absence of capillary network which normally displaces pressure, without it the pressure raises too high and ruptures

Question 7

Causes of Subarachnoid hemorrhage?

Answer 7

aneurysm or anterio-venous infarction

Question 8

What is a subarachnoid hemorrhage?

Answer 8

bleeding into the subarachnoid space

Question 9

5 most common symptoms of a stroke

Answer 9

1. Sudden confusion, trouble speaking, or understanding others
2. Sudden numbness or weakness of the face, arm, or leg
3. Sudden trouble seeing in one or both eyes
4. Sudden dizziness, trouble walking, loss of balance
5. Sudden severe headache with no known cause

Question 10

Cognitive changes seen with stroke patients

Answer 10

• Denial of illness
• Spatial and proprioceptive dysfunction
• Impaired memory, judgment
• Inability to concentrate and attend to tasks

Question 11

Proprioception

Answer 11

sense of body position in space

Question 12

Symptoms of Right Hemispheric Stroke?

Answer 12

• Proprioception – sense of body position in space
• Personality changes – impulsivity and poor judgement
• Disorientation
• Impaired sense of humor – Becky/Emma
• Inability to hear tonal variations – Evan doing karaoke
• Left visual field impairment

Question 13

Apasia

Answer 13

inability to comprehend language

Question 14

Alexia or dyslexia

Answer 14

reading problems

Question 15

Agraphia

Answer 15

difficulty writing

Question 16

Acalculia

Answer 16

not Asians

Question 17

Symptoms of Left Hemispheric strokes

Answer 17

• Aphasia – inability to comprehend language
• Alexia or dyslexia – reading problems
• Agraphia – difficulty writing
• Acalculia – inability to do math
• Right visual field impairment

Question 18

Equation for Cerebral Perfusion Pressure

Answer 18

MAP - ICP = CPP

Question 19

Normal CPP

Answer 19

60 to 100

Question 20

Normal ICP

Answer 20

5 to 15

Question 21

What do you assess when you do a neuro assessment?

Answer 21

• Vitals
• Motor strength
• Cranial nerves
• Pupil assessment
• Glasgow coma scale

Question 22

Worst score on the Glasgow coma score?

Answer 22

15

Question 23

Early symptoms of increased ICP?

Answer 23

• Change in LOC
• Decreased motor function
• Headache
• Vomiting
• Ocular signs

Question 24

Decorticate posture

Answer 24

arms flexing towards the spinal cord

Question 25

Decerebrate posture

Answer 25

arms pronating and extending

Question 26

Late symptoms of ICP

Answer 26

• posturing
• hyperthermia
• vitals change

Question 27

Cushing’s Triad

Answer 27

bradycardia
irregular respirations
hypertension
widening BP pulse pressure

Question 28

Broca’s aphasia

Answer 28

Unable to convert thoughts to meaningful language, outburst of profa F#%$ S*&^T, aware of deficits

Question 29

Wernicke’s aphasia

Answer 29

Unable to understand spoken and written word

Question 30

Dysarthria

Answer 30

tongue and facial weakness

Question 31

Subarachnoid precautions

Answer 31

– decrease stimuli, head and neck alignment, avoid hip flexion, no enemas!

Question 32

NIHSS stroke scale

Answer 32

low good, high bad

Question 33

Teaching to avoid neglect…

Answer 33

Remind pt to touch both sides of body
Dress affected side first
Remind them of safety issues, put safety procedures in effect (bed alarms, etc)