CVA Flashcards
1
Q
what are all the names for a stroke?
A
brain attack, CVA, TIA
2
Q
what does CVA stand for
A
cerebral vascular accident
3
Q
what exactly is a stroke?
A
sudden loss of brain function due to loss or disruption of blood supply to brain which results in functional CNS abnormalities
4
Q
what are the two types of stroke?
A
ischemic and hemorrhagic strokes
5
Q
what is an ischemic stroke?
A
some sort of blocked BV in brain obstructing BF
can be caused by a thrombosus or embolism
6
Q
what is a hemorrhagic stroke
A
ruptured BV that leaks in brain
7
Q
what can cause a hemorrhagic stroke
A
hypertension, cerebral anurism
something that ruptures BVs
8
Q
what can cause a ischemic stroke?
A
atherosclerosis
(hardening and thickening of BVs that can close off and cause ischemia)
9
Q
what are lifestyle choices, diseases, and drugs that cause ischemic strokes?
A
hypertension, atherosclerosis
high cholesterol
diabetes
drugs
oral contraceptives
smoking
10
Q
what can cause a embolic stroke?
A
atrial fibrillation
11
Q
what can cause a hemorrhagic stroke
A
HTN or aneurysm
12
Q
what does bleeding in the brain do?
A
creaes pressure on brain tissues which causes loss of perfusion which causes ischemia and leads to tissue death
13
Q
what is a TIA
A
mini strokes
transient ischemic attack
14
Q
what are risk factors of strokes
A
HTN
diabetes
A FIB
smoking
high cholesterol
no physical activity
stroke history in family
15
Q
what are risk factors that you can modify?
A
smoking
weight
exercise
alcohol use
16
Q
what does a TIA do to someone?
A
loss of BF to brain resulting in temporary neurologic dysfunction
17
Q
what can initiate a TIA if someone gets them often?
A
exertion of body
standing up, strenuous exercise
18
Q
what does a TIA warn you?
A
impending CVA within 2-5 years
19
Q
what are S/S of TIA
A
temporary visual, motor, sensory, and speech deficits
confusion
20
Q
what pulse may be diminished with someone with TIAs?
A
diminished carotid pulses
21
Q
what is syncopy
A
passing out
22
Q
What is BEFAST?
A
Balance
Eyes
Face
Arms
Speech
Time
23
Q
what are the suddens?
A
Sudden
numbness/weakness in face arm legs
confusion, trouble speaking/understanding
trouble seeing
trouble walking. dizziness
severe headache
24
Q
what types of strokes or brain issues can be identified using a non contrast CT
A
thrombosis
embolism
hemorrhage
cerebral edema
25
what can a MRI/MRA help diagnose?
tissue perfusion
26
what can a brain scan/ angiography help diagnose?
brain ischemia
27
what can labs help diagnose?
clotting factors (PT, PTT,INR)
H/H
platelets
28
what can a EEG help diagnose?
seizures
29
what are 3 stroke damage assessment scales?
NIHSS (NIH)
glasgow coma scale
neurological flow sheet
30
With a NIH score, if someone gets a low score, what does that mean?
low score is good, pt doesnt have deficits
31
what is dysarthria
trouble speaking
32
what is limb ataxia
no coordination
33
what is extinction?
neglect they have a arm or leg
34
with NIH, a high score is good or bad?
Bad
35
what is the best score someone can get on the GCS assessment
15, normal
36
what score does someone in a coma get using the GCS
7
37
what side of the body is affected by a R brain CVA?
left side effected
38
what side of the brain is effected by a L brain CVA
R side effects
39
what is aphasia?
inability to comprehend or formulate language
40
what is agraphia
inability to write
41
what is alexia
inability to read
42
what is acalculia
inability to calculate
43
what side of the brain is the CVA on if your patient has aphasia, agraphia, alexia, and acalculia
L hemisphere
44
When someone has a stroke, what is the most common stroke? (ischemic or hemmoragic) and (Left or Right sided strokes) What is the average percent at which people when they have strokes have this type of stroke?
Ischemic L hemisphere strokes
80% (for both ischemic and L sides)
45
who may have a better time recovering from a stroke, a L hemi or R hemi stroke patient?
L hemi
46
what are symptoms of a R hemisphere stroke?
disorientation
visual/spatial/depth perception deficits
unaware of deficits
worse prognosis
47
who is more difficult to rehab, L or R hemi strokes?
R hemi stroke pts
48
what is the typical mood response to a L CVA?
frustration, pessimistic
49
what is apraxia
inability to do simple purposeful movements
50
what is hemiparesis
one sided weakness
51
what is agnosia
inability to recognize objects, people, or sounds
52
what is homonymous hemianopsia?
vision cuts
53
if your pt has a L CVA, where would they experience homonymous hemianopsia?
R eye vision cuts.
54
if your pt has a R CVA, where would they experience homonymous hemianopsia?
L vison cuts
55
what is normal ranges for pupil size?
2-5mm
56
if a pt has a oval shaped pupil, what can that indicate?
increased ICP
57
if your pupils have a sluggish response when constricting to light, what can that indicate?
increase in ICP
58
what are S/S of ICP
headache
N/V
High BP
confusion
fixed pupils
seizures
LOC
59
what are major motor function deficits
flaccid, paralysis
bowel/bladder incontenece
gait/coordination
dysphagia, gag reflex
60
what are major sensory functional deficits
vision
hearing
tactile
neglect syndrome
61
what is major memory functional deficits
short term memory loss
62
what are the 4 major functional speech deficits? what sided stroke would cause these problems?
aphasia
alexia
agraphia
acalculia
L sided
63
what is the penumbra
part of brain that is at risk of progressing to infarction but can be repaired if caught in time
64
what are some interventions for TIA?
safety
anticoagulants
antiplatelets
lipid lowering agents
antihypertensives
diet modification
65
what is the general goal you want to achieve when treating an ischemic stroke?
reperfuse the brain tissue
66
how much time can you wait to use a clot buster (tPA)?
3- 4.5 hours
67
if your patient has an ischemic stroke, where do you want to get the BP hovering around?
140-150
68
what is the general goal to treat for a hemorrhagic stroke?
stop the bleeding, plug the leak
69
what should the nurse be watching for with a patient with a hemorrhagic stroke? What do you want the BP to hover around?
watch for ICP and keep BP <140/90
70
in the rehab phase, the HOB must be around what degree? and why?
30-45 degrees, dysphagia precautions
71
until swallow eval, a patient must be put on what diet after a stroke?
NPO
72
if your pt doesnt pass swallow eval, what may they need for nutrients?
tube feeding
73
if im transferring a patient to a wheelchair, what side should the pt lead with? affected or unaffected
the unaffected side
74
when is someone in the acute phase post stroke?
first 72 hours post stroke
75
when does the rehab phase of a stroke start?
the day of stroke
76
what are some medications you can give to a patient in the acute phase post stroke
diuretics, anticoagulants, anticonvulsants, antihypertensives
77
what type of stroke can be treated with thrombolytic therapy?
ischemic
78
what type of stroke can be treated if caught in time with tPA?
ischemic stroke
79
what type of stroke can be treated with a clot retrieval?
ischemic stroke
80
what type of stroke can be treated with a cerebral angioplasty?
ischemic stroke
81
what is hydrocephalus
water in brain that causes increase in ICP
82
what is atherosclerotic plaque?
build up of fat and other substances that stick to arterial wall and obstruct BF
83
what is bruit?
a sound heard in stethoscope that indicates turbulent blood typically due to obstructed BVs
84
what is carotid stenosis
hardening and narrowing of artery which lowers BF to brain
85
what is CTE
chronic traumatic encephalopathy
degenerative brain disease due to head trauma
86
what is a concussion
traumatic injury to brain that may result in unconsciousness
87
what is a craniotomy
surgical incision to open cranium and allow access to brain
88
what stroke can be helped with a craniotomy?
hemmoragic
89
what is diplopia
double vision
90
what is dysarthria
slurred speech caused by muscle weakness/paralysis
91
what is a embolectomy
surgical blood clot removal
92
what is a embolic stroke
stroke caused by embolus (dislodged clot)
93
what does it mean when someone is a emotionally lability
uncontrollable emotional state with pts who have had a stroke or other brain injury
94
what is a epidural hematoma
accumulation of blood in a clot that results from arterial bleeding into a space between dura and inner skull
95
what is expressive aphasia? what part of the brain is damaged to cause this?
aphasia that is the result of damage in the frontal lobe
96
what is hemianopsia
condition where vision of one or both eyes are affected
97
what is hemiparesis
one sided weakness of body affecting an arm and or leg
98
what is hemiplegia
one sided paralysis of body affecting arms and or legs
99
what is hydrocephalus
increased cerebrospinal fluid in brain
100
what is hyperbaric oxygen therapy?
intervention to provide high dose of oxygen to help with ischemia and hypoxia
101
what does it mean if someone has impaired airway defense
inability to clear someones airway
102
what is a infratentorial tumor
tumor under the tentorium
103
what is a intracerebral hemorrhage
accumulation of blood within brain tissue caused by tearing of small arteries and veins in white matter
104
what is nystagmus
invuluntary movement of eyes
can move vertically or horizontally
105
what is organ procurement
process of donating an organ from a person that is brain dead or organ donor
106
what is papilledema, what can this indicate?
edema and hyperemia of optic disc
sign of high ICP
107
what is hyperemia
increased BF
108
what is photophobia
sensitive to light
109
what is proprioception
body position sense
110
what is ptosis
eyelid drooping
111
what is receptive aphasia
cant understand when spoken to but can talk
112
what is vertigo
feeling of spinning or dizziness
113
In the GCS, whats the 3 responses you test?
eyes, verbal, motor
114
how many points can you score for the eyes response in gcs
4
115
how many points can you score for the verbal response in gcs
5
116
how many points can you score for the motor response in gcs
6
117
how many points in total can you score on gcs
15
118
what is the pneumonic you can remember for gcs?
MVE-654
119
what are things that your patient may have that may affect the GCS rating?
anything that disrupts the patients ability to participate in responses
verbal: intubation
eye opening: swelling of the eyes shut
motor: paralysis
120
what does causing central stimuli pain test for?
tests brains response to pain
121
what does causing peripheral stimuli pain test for?
tests spinal cords response to pain
122
to test your patients response to peripheral stimuli, where can you create pain?
pressure on nail bed
123
