CH 49

Question 1

What is a TRANSIENT ISCHEMIC ATTACK?

Answer 1

blockage of blood to the brain
-depriving oxygen and glucose
Lasts minutes to hours- recover completely
1/3 of pt with TIA will have a STROKE in 5 future

Question 2

What is a penumbra?

Answer 2

area of brain tissue surrounding the damage

Question 3

What are 2 types on ischemic stokes?

Answer 3

Thrombotic

Embolic

Question 4

An ischemic stroke occurs when…

Answer 4

blood supply to brain is blocked or slowed

Question 5

Thrombotic stroke occurs when…

Answer 5

occlusion builds up in artery

*internal or common carotid artery

Question 6

Embolic stroke occurs when…

Answer 6

blood clot created (typically in heart), travels through arteries and traps in small vessel.

Question 7

Hemorrhagic stoke are caused by..

Answer 7

rupture of cerebral blood vessel, allowing blood to escape in brain tissue.

Question 8

What are the 2 types of HEMORRHAGIC STROKE?

Answer 8

Subarachnoid Hemorrhage

Intercerebral Hemorrhage

Question 9

What is subarachnoid hemorrhage?

Answer 9

ruptured cerebral aneurysm, occurs on surface of brain

Question 10

What is a intracerebral hemorrhage?

Answer 10

caused by uncontrolled hypertension, deeper tissues of brain

*may experience undetected many times.

Question 11

Modifiable Risk Factors for Stroke

Answer 11

HTN
Smoking
Diabetes
CV disease, Atrial fib
Asymotomatic carotid stenosis
TIA
Sickle cell anemia
Dyslipidemia
Obesity
Alcohol
Poor diet, No exercise
Postmenopausal hormone therapy

Question 12

Nonmodifiable Risk factors Stroke

Answer 12

older age
gender (MALE)
Heredity
prior stoke or heart attack

Question 13

Warning signs of a stroke

Answer 13

Numbness or weakness in face, arm, leg (one side of body)
Confusion, trouble speaking
trouble seeing in one or both eyes
Trouble walking, dizziness, loss of balance
Severe HA, no cause

Question 14

Remember FAST

Answer 14

FACE droop
ARMS drift
SPEECH
TIME

Question 15

Acute S&S of stroke include:

Answer 15

one side weakness/paralysis
Dysphagia
Sensory loss
Mental status change
Visual disturbances
Speech Disturbances

Question 16

What is global aphasia?

Answer 16

both receptive and expressive aphasia are present

Question 17

What is dysarthria?

Answer 17

slurred or indistinct speech (lack of coordination)

Question 18

What is ataxia?

Answer 18

poor balance and stumbling, staggering gait

Question 19

Homonymous hemianopisia is..

Answer 19

visual deficit on same side half of each visual field

Question 20

CT scan is vital in diagnosing and treating a….

Answer 20

hemorrhagic stroke

Question 21

Other tests to be completed upon arrival in ER…

Answer 21

EKG
CBC, Electrolytes, glucose
Metabolic panel
PT, INR
NIH Stroke Scale
Carotid Doppler
Cerebral Angiogram

Question 22

What will the nurse monitor, while results are pending? (hemorrhagic or ischemic)

Answer 22

A’ airway
-O2 if sat >92%, and LOC decreased
B’ breathing
C’ circulation

 - Vitals and heart rhythm are monitored
 - temp >99.6 treated
 - IV fluids - NO glucose
 - tPA                  -BP control

Question 23

A thrombolytic can be administered within…

Answer 23

3 hours of onset for ischemic attacks

Question 24

Patients suffering from a stoke are at risk for

Answer 24

ICP——> brain damage

Further stokes

Question 25

If receiving tPA, BP must be maintained..

Answer 25

below 185/110

Question 26

What antihypertensive meds will a stoke pt receive?

Answer 26

``` beta blockers (labetalol) calcium channel blocker (nicardipine) ```

Question 27

Prevention of DVT includes:

Answer 27

SCD's/ elastic stockings heparin warfarin lovenox

Question 28

Meds for CV Disorders

Answer 28

Thrombolytic Antiplatlet Anticoagulants Statins

Question 29

What is an endartectomy?

Answer 29

surgical removal of occlusion from artery If not a good candidate, carotid angiogram with stent may be used

Question 30

Right side Infract

Answer 30

Left sided weakness/ paralysis Impaired judgement/ safety risk Unilateral neglect indifferent to disability

Question 31

Left side Infract

Answer 31

Right sided weakness Aphasia Depression r/t disability

Question 32

Stoke Prevention includes:

Answer 32

Controlling weight, HTN, Cholesterol NO smoking Aspirin, Warfarin

Question 33

Signs and symptoms of small hemorrhage:

Answer 33

mild headache, vomiting, disorientation "flu like symptoms" **may not seek tx

Question 34

A rupture of an aneurysm will present as a..

Answer 34

``` severe headache changes in LOC ICP Generalized seizures Nuchal Rigidity ```

Question 35

Diagnosis of an aneurysm requires

Answer 35

cerebral angiogram | CT scan