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NUR 211 Exam 2 > Exam 2 > Flashcards

Exam 2 Flashcards

(103 cards)

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1
Q

Stroke is also called

A

brain attack / cerebrovasular accidents

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2
Q

What is a stroke?

A

Disruption in the cerebral blood flow secondary to ischemia, hemorrhage, brain attack or embolism.

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3
Q

Name 3 types of strokes

A

Thrombotic stroke ( ischemic)
Embolic Stroke ( ischemic)
Hemorrhage stroke ( bleeding directly into the brain.)

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4
Q

What type of stroke can be reversed?

A

Ischemic strokes

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5
Q

Ischemic strokes incldes what types of stroke?

A

Thrombotic and embolic

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6
Q

Ischemic strokes can be reversed by?

A

fibrinolytic therapy using alteplase, also known as (TPA) tissue plasminogeb activator . if given within 3-4.5hrs of initial manifestations.

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7
Q

What is a hemorrhagic stroke?

A

Bleeding directly into the brain. Can be suddden onset of symptoms.

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8
Q

Hemorhagic stroke is secondary to what?

A

Ruptured artery or aneurysm

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9
Q

Seizures are common in which types of stroke?

A

Hemorrhagic stroke

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10
Q

Describe a Thrombotic stroke (Ischemic)

A

-Secondary to the development of a blood clot on an atherosclerotic plaque in the ( originates in) cerebral artery.
- Evolve over a period of several hours to days.
-Symptoms get progressively worse as the infarctin and edema increase.

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11
Q

Describe a Embolic Stroke ( Ischemic)

A
  • Caused by embolus traveling from another part of the body to a cerebral artery.
  • Can Cause LOC ( Loss of consciousness)
  • sudden, severe symptoms, headache
    -Warning signs are less common.
    -Client remains conscious and may have a headache.
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12
Q

Strokes are common in which ethics groups?

A

-Mexican Americans
-Latin Americans
-African Americans
-Japanses and Chinses
- Gender ( men survival for than women)
- age > 55

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13
Q

Risk Factors for a stroke

A
  • Cerebral Aneurysm
    -Arteriovenous Malformation (AV)
    -Atherosclersis
    -Hypertension
    -Anticoagulation therapy
    -Diabetes
    -Stress
    -Obesity
    -Oral Contraceptives
    -hypercoagulability
  • hypercholesterolemia
    -A.Fib
    -Smoking, cigarettes
    -Cocaine us ( illicit drug use)
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14
Q

Right side of the brain is responsible for?

A

visual, spatial awarness, and proprioception

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15
Q

Left side of the brain is responsible for?

A

(MAL) Language, Math skills and analytic thinking

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16
Q

Right-side Brain Damage

A

-Impaired judgment
-impaired time concept
-Impulsive, safety problem ( Overestimation of abilities)
-Left-side neglect
-Paralyed left-side: Hemiplegia
-Rapid performance, short attention span
-Spatial-pereptual defictis
-Tends to deny or minimize problems
-Visual changes (Hemianopsia)
-Loss of depth perception

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17
Q

Left-side brain damage

A

-Aware of deficits: depression, anxiety, anger, quick to become frustrated.
-Imparied comprehension related to language and math.
-Imparied right/left discrimination
-Imparied speech/language aphasias
-Paralyzed right side: Hemiplegia
-slow performace, cautions.
-Angosia ( unabble to recognize familiar objects)
-Agraphia ( difficulty writing)
-Alexia ( difficulty reading)
-Hemianopsia ( visual changes)
-Loss of visual field in one or both eyes.

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18
Q

Contralateral side:

A

Opposite side if the body

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19
Q

If the right side of the brain is damaged, which side is affected?

A

The left side is affected

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20
Q

If the left side of the brain is damaged, which side is affected?

A

the right side is affected

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21
Q

Which motors skills are in the frontal lobe?

A

Smell, Speech, concentraption, planning, problem solving, motor control

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22
Q

Which motor skills are in the parietal lobe?

A

touch and pressure, taste, body awarness

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23
Q

which motor skills are in the temporal lobe?

A

Hearing, facial recognition

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24
Q

Which motor skills are in the occipital lobe?

A

vision

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25
Which motor skills are in the cerebellum lobe?
Coordination
26
Frontal lobe contain?
Broca's area
27
Tempopraietal lobe is apart of what area?
Wernick's area
28
The brainstem is responsible for?
breathing, consciousness, blood pressure, HR and sleep.
29
where is the hippocampus found?
inner folds of the temporal lobe
30
What is the Hippocampus resoponsible for?
learning and memory
31
Anterior cerebral artery includes?
frontal lobe, parietal lobe, most of the temporal lobe
32
Middle cerebral artery inculde:
small part of temporal lobe
33
Posterior cerebral artery include?
occipital and small part of temporal lobe
34
Expressive aphasia
unable to communicate verbally (Damage to the Broca's areas of the frontal lobe)
35
Receptive aphasia
unable to understand the spoken and written word. ( damage to the Wernicke's area, temporoparietal lobes)
36
Global (mixed) Aphasia
Dysfunction occurs in expression and reception
37
Agnosia
unable to recognize familiar objects
38
Alexia
reading difficulty
39
Agraphia
writing difficulty
40
Hemiplegia
one side paralysis
41
paresis
weakness
42
Hemiparesis
one-side weakness
43
Hemianopsia
loss of half the visual field in one eye or both
44
Homonymous Hemianopsia
Loss if vision in the same half of the visual fiels of each eye
45
proprioception
The body's ability to sense its location, movement and actions
46
ataxia
imparied balance ir coordination
47
dysphagia
difficulty swallowing
48
Dysarthria
difficulty or unclear articulation ( garbled speech)
49
Nuchal rigidity
neck stiffness, inability to move the neck muscles
50
Apraxia
inability to execute skilled movement or gesturs despite having the ability and desire to perform them.
51
B.E F.A.S.T. means? (s/s of a stroke)
B. balance issues E. eyesight changes F. facial drooping A. arm waekness S. speech difficulties T. Time to call 911
52
Ways to diagnose a stroke?
CT MRI Magnetic Resonance Angiography Lumbar puncture Glasgow coma scale
53
What is the time frame for a stroke assessment and results?
Door-CT: within 25 mins of arrival to ED Door- CT results: within 45 mins of arrival to ED
54
What is a CT scan for?
Determination of the type of stroke. Ischemic vs hemorrhagic
55
MRI is used for?
Identify edema, ischemia, and necrosis
56
Magnetic Resonance Angiography is used for what?
To identify the presence of a cerebral hemorrhage, abnormal vessel structures, vessel ruptures and regional perfusion of blood flow in the carotid arteries and brain.
57
Reason for a lumbar puncture?
To assess for the presence of blood in the cerebrospinal fluid. A postive finding is consistent with a cerebral hemorrhage or ruptured aneurysm.
58
Reason to use the Glasgow Coma scale?
used when the client as a decrease in LOC or orientation.
59
Antidote for Thrombolytics
Amicar ( aminocaproic)
60
When are thrombolytics given?
Within 4.5hrs. of initial manifestation for clients who experiencing embolic stroke evidence by CT scan results.
61
Thrombolytics are given for which type of stroke?
Embolic ( Ischemic)
62
Name two thrombolytic medications?
Alteplase Rereplase
63
How are thromboltic medications given?
IV push bolus, Followed by weight-based infusion over 1-hr.
63
Thromboltics should reconstituted with?
sterile water
63
What size needle is used when given a thrombolytic?
18g
64
Name two contraindications for using a thrombolytic med?
uncontrolled hypertension Hemorrhagic stroke
65
nursing interventions for thrombolytic meds
-start 2 IV line prior to initiation - Assess for bleeding q15 mins -Assess VS - Assess LOC -Monitor labs ( type &cross) ( have bleed ready @ all times.) - bedrest during therapy - Avoid IM/ SQ injections - Apply prolonged pressure after a arterial or venous punctures. - Assess for s/s of PE or MI ( clots can dislodge & travel)
66
Labs to monitor when using thrombolytic meds/
(H.P.P) Hgb/HCT PLT PT/PTT
67
S/s of bleeding
Nose bleeds bleeding gums Bruising/petechiae Black-tary stools
68
important client teaching for thrombolytic meds?
-purpose of the drug - report unusual bruising or bleeding, rash or SHOB - avoid shaving or vigorous tooth brushing - notifiy HCP of pregnacy or breastfeeding
69
Top 4 Side effects for thrombolytic
GI bleeding, GU bleeding, Allergic Rxn, intercranial bleeding
70
Name 3 anticoagulants
Warfarin, Heparin, Enoxaparin
71
anticoagulants are given for what type of stroke?
Cardioemobolic stroke
72
What type of stroke should not use anticoagulants?
Hemorrhagic stroke
73
What is the antidote for heparin?
protamine sulfate
74
What the antidote for warfarin?
Vitmain K
75
actions of anticoagulants
-interferes or inactivates clotting factors - prevent clots from forming - prevent futher clot growth - short-term therapy ( heparin / enoxaparin) - long-term therapy ( warfarin)
76
Side effects of anticoagulation?
HIT* ( heparin-induced thrombocyopenua) Rash Anemia Fever Alopecia Ecchymosis Osteoporosis
77
Nursing intervention for anticoagulation?
-assess for bleeding -assess VS -Montior labs -MAY CAUSE HYPERKALEMIA -MAY INCREASE AST AND ALT (LEFTs) - bedrest during therapy -Avoid IM/SQ injections -Apply prolonged pressure to arterial or venouse puntures sites,
78
While on heparin. Which labs should be monitored?
aPtt
79
While on PO warfarin. Which labs should be watched?
PT/INR
80
What are contrindictions when taking anticoagulates?
-bleeding disorder (Thrombocytopenia) -Ulcer disease -Hemorrhagic stroke or active bleeders - Uncontrolled HTN -Pregnant/lactating
81
Therapeutic level of aPTT?
1.5-2.5 times the normal valuse Normal value is 30-45 seconds.
82
Dietary teaching for client on anitcoagaluates?
leafy greens contains high levels of vitamin K, which makes the warfin less effective.
83
client teaching for anticoaglautes
-explain purpose of medication/ need for close monitorning. -Report unusual bruising, bleeding, rash or SHOB - Do not take aspirin, NSAIDs whil on heparin -Only use electric razor -Take PO medication at same time each day ( in the evening) - Avoid alcohol -Notify HCP of pregancey or breastfeeding -notifiy HCP med regimen before surgery -Carry ID card
84
Complications of stroke
-Dysphagia -aspiration -unilateral neglect -Constipation -Urinary incontinence
85
Novel oral anticoagulants is an alterative medication to what type of drug therpy?
Warfarin
86
NOACs (novel oral anticoagulants ) are given for what type of stroke? (Dabigatran, apixaban, Rivaroxaban)
Ischemic ( cardiembolic stroke)
87
Antiplatelelts are given for what type of stoke? ( aspirin, dipyridmole, clopidogrel)
ischemic stroke
88
What type of medication is used for seizures after a stroke?
antiepileptic ( phenyton and gabapentin)
89
If the blood pressure is low after a stoke. What dose that mean?
If the Bp is low this could indicate that the stroke is actually getting worse and there is a decrease to cerebral perfusion.
90
Nursing diagnose for a stroke?
The nursing diagnoses are based on the assessment finding of the client.
91
young-old
65-75
92
old
75-85
93
old-old/oldest old
85-up
94
Types of conflicts: intrapersonal
within a person
95
types of conflicts: interpersonal
between and among clients, nurses, or other staff members.
96
Types of conflict: organizational
When a employee confronts the policies and procedures of an organization.
97
Charaterics of avoidance
- unassertive -uncooperature -do not pursue their own needs, goals, or concerns -Postpone dealing with issues
98
charaterics of Accommodation
-neglect their own needs, goals or concerns while trying to satisfy those of others. - Obeys and serves others -Feels resentment and disappointment because they " get nothing in return"
99
charaterics of competition
-pursue their own needs, goals at the expense of others. -Stands up for rights -Defends important principles
100
Charaterics of compromise
-assertive -cooperative -Works creatively and openly to find solutions that satisfies most all-important objective and goals.
101
how to resolve conflict
(Always aim for a win-win resolution) -identify the source of the conflict - Generate possible solutions -Evaluate suggested solutions -choose the best solutions -implement the chosen solution -Evaluate: is the conflict resolved

NUR 211 Exam 2 (1 decks)

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