Chapter 6 - Acquired Brain Injury

Question 1

Stroke is also known as:

Answer 1

Cerebrovascular accident, which occurs when blood supply to the brain is disrupted.

Question 2

Ischaemic stroke -

Answer 2

Due to a blocked artery can be caused by either an emboli or a thrombus.

Question 3

Haemorrhaging stroke -

Answer 3

Bleed out in brain, blood vessel ruptured.

Question 4

Risk factors for stroke include:

Answer 4

Hypertension 
Obesity 
Cigarette smoking 
Diet high in cholesterol
Alcohol 
Lack of exercise 
Diabetes 
Atrial fibrillation

Question 5

APPT is a clothing measure of bloods and stands for:

Answer 5

Activated partial thromboplastin time

Question 6

A normal GCS is:

Answer 6

15

Question 7

Stroke should be considered a medical emergency as:

Answer 7

Diagnosis and treatment with tPA needs to occur within four and a half hours from onset of symptoms

Question 8

A thrombus which has broken loose and is moving with the blood flow is called:

Answer 8

An embolism

Question 9

Atheroma is:

Answer 9

Fatty plaque on the wall of an artery

Question 10

A stroke-in-evolution is:

Answer 10

A thrombotic stroke that occurs rapidly but then progresses slowly over 2-3 days.

Question 11

The immediate treatment for a stroke includes:

Answer 11

Receiving a thrombolytic in the Emergency Department once a CT scan has been done.

Question 12

Which is the most important goal in the immediate phase of acute stroke care?

Answer 12

Minimal damage to the penumbra and re-establish perfusion as quickly as possible.

Question 13

Difference between the systolic and diastolic pressure is called the:

Answer 13

Pulse pressure

Question 14

4 common cues during stroke :

Answer 14

Pattern of breathing
Headache
Nausea/vomiting
Presence of papilloedema

Question 15

List three factors that can impair cerebral auto regulation:

Answer 15

• Increase arterial pressure
• Increased hydrogen ions from increased CO2
• A fall in Pa02

Question 16

What are the two major arteries supplying the brain?

Answer 16

Cerebral and vertebral

Question 17

Cushings triad is associated with:

Answer 17

Raised intracranial pressure

Question 18

Three parameters that form cushings triad:

Answer 18

• Raised pulse pressure
• Decreased pulse
• Abnormal breathing pattern

Question 19

Mannitol is an osmotic diuretic. It would be most likely to be given for:

Answer 19

Cerebral oedema

Question 20

The rigid cranial cavity contains three non-compressible elements:

Answer 20

• The brain 80%
• CSF 8%
• Blood 12%

Question 21

The Monroe - Kellie hypothesis is when:

Answer 21

Any of the 3 components increases, the volume of the others must decrease to maintain equilibrium. (Brain, CSF, Blood)

Question 22

Normal intracranial pressure is:

Answer 22

0-10mmHg

Question 23

3 signs which usually are not causative of confusion and altered level of consciousness:

Answer 23

• Hypertension
• Hypo/hyoerkalemia
• Hyponatraemia

Question 24

Which of the folllowing is not a risk factor for developing artherosclerosis?

• Male
• Diabetes
• Smoking
• High HDL level
• High dietary fat intake

Answer 24

High HDL level

Question 25

Early warning signs of altered level of consciousness include:

Answer 25

- GCS<12 - A drop in GCS by 2 points - BGL 1-2.9mmol/L - Any seizure

Question 26

Late warning signs of altered level of consciousness are:

Answer 26

- GCS < or = 8 - Unresponsive to verbal command - BGL < 1 mmol/L

Question 27

Hemiplegia:

Answer 27

Paralysis of the left or right half of body

Question 28

Aphasia/dysphasia

Answer 28

Difficulty speaking/incomprehensible speech or inability to understand speech

Question 29

Dysarthria

Answer 29

Difficulty speaking/pronouncing words

Question 30

Hemianopia

Answer 30

Loss of half of the visual field of one or both eyes

Question 31

Unilateral neglect

Answer 31

Unaware of and inattentive to one side of the body

Question 32

Agnosia

Answer 32

The inability to recognise previously familiar objects

Question 33

Diplopia

Answer 33

Unilateral or bilateral double vision

Question 34

Dysphagia

Answer 34

Difficulty swallowing

Question 35

A stroke patient having decreased mobility increased the risk of:

Answer 35

DVT - Deep vein thrombosis

Question 36

When monitoring for thrombophlebitis, limbs should be assed for:

Answer 36

Increased warmth, increased redness and increased calf circumference

Question 37

Hypothermia may develop in a stroke patient due to damage to the:

Answer 37

Hypothalamus

Question 38

Stroke patients who have dysphagia May become:

Answer 38

Malnourished

Question 39

Chest physiotherapy -

Answer 39

To prevent chest infections such as aspiration/pneumonia.

Question 40

Anti-embolic stockings and early mobilisation-

Answer 40

To prevent thrombophlebitis and contractures

Question 41

Monitor vital signs and respiratory status-

Answer 41

To detect early developing complications such as pneumonia, bleeding

Question 42

Assess for warmth, redness and increase size of calves -

Answer 42

To monitor development of thrombophlebitis

Question 43

Face patient, speak slowly and allow for answers -

Answer 43

To maintain patient dignity and decrease frustration with communication

Question 44

Encourage fluids and high fibre diet -

Answer 44

To prevent constipation