Exam 3 Flashcards
(188 cards)
1
Q
Signs and symptoms of anemia
A
Palpitations
Fatigue
Weakness
Worse:
Pallor
*Chest pain
*Dyspnea
*Increased RR
*Increased HR
(Anemia is serious when RR and HR need to compensate)
2
Q
What is included with a CBC with differential?
A
RBC
Hemoglobin
Hematocrit
3
Q
Normal values for hemoglobin
A
Males: 14-17
Females: 12 to 15
4
Q
Normal values for hematocrit
A
Men: 41-50
Women: 36-48
5
Q
What do iron tests look for?
A
Ferritin
Serum iron
(To diagnose anemia)
6
Q
What does a reticulocyte count do?
A
Reflects bone marrow activity when diagnosing anemia
7
Q
What things are looked at when testing for anemia?
A
RBC
Hemoglobin
Hematocrit
Iron studies
Reticulocyte count
Folic acid
Cobalamin (vitamin B12)
Bilirubin
Blood type and screen
8
Q
Level of hemoglobin when a blood transfusion is needed?
A
7
9
Q
What causes iron deficiency anemia?
A
Inadequate intake of iron, malabsorption, blood loss or hemolysis
10
Q
Characteristics of RBCs with iron deficiency anemia
A
Microcytic, Hypochroic
(Small and pale RBCs)
11
Q
Symptoms of iron deficiency anemia
A
Pallor = most common symptom
Glossitis (shiny, red, beefy tongue) = 2nd most common
HA, paresthesias, burning sensation of tongue
12
Q
Treatment of iron deficiency anemia
A
Dietary or iron supplements
*Dietary intake:
- dark leafy greens
- red meat (esp organ meats)
- iron fortified foods
13
Q
How can you prevent oral iron from staining pt’s teeth?
A
Have them drink it through a straw
14
Q
What causes megaloblastic anemias?
Two types of megaloblastic anemias
A
A problem with DNA synthesis:
- cobalamin deficiency
- folic acid deficiency
15
Q
Difference between cobalamin deficiency anemia and pernicious anemia
A
Low B12 causes DNA synthesis to be impaired because without it, folic acid cannot get into cell (low B12 = low folic acid absorption)
Without intrinsic factor, cobalamin cobalamin cannot get into cell (low intrinsic factor = low B12 absorption) *does not have neuromuscular symptoms
16
Q
Causes of cobalamin deficiency anemia
A
Autoimmune
Surgical removal of parts of stomach
Vegan/vegetarian diets
Excessive alcohol use
Smoking
Long term H2 blocker / PPI use
17
Q
Symptoms of cobalamin deficiency anemia
A
Jaundice
Glossitis
Fatigue
Weakness
N/V
Abdominal pain
Neuromuscular symptoms such as paresthesias of hands/feet, gait disturbances
18
Q
Interventions for cobalamin deficiency
A
Vitamin B12 (oral for pts with proper absorption only)
Dietary counseling: animal proteins, dairy, eggs, fortified cereals
19
Q
Causes of chronic anemia disease
A
Chronic inflammation
Autoimmune disorders
Infectious disease
Malignancy
HF
(Immune issue (cytokines) can’t put iron into storage)
20
Q
*What is aplastic anemia?
A
*Decline in all cells due to bone marrow depression *(pantocytopenia)
21
Q
Treatment of aplastic anemia
A
*Remove or treat cause if known
Immunosuppressive meds
Colony stimulating factors
Hematopoietic stem cell transplantation
Nursing interventions:
- prevent complications due to bleeding risk and infection
22
Q
Acquired causes of hemolytic anemia
A
Destruction of RBC that is faster than production of RBCs
- Physical destruction such as DIC
- Antibodies produced against RBCs
- Infectious
23
Q
Most common symptom of hemolytic anemia why?
A
Juandice
Because increased bilirubin which is a byproduct of hemolysis
24
Q
Treatment for hemolytic anemia
A
IV fluids to protect the kidneys
Transfusion
Steroids
(Removal of the cause is the ultimate goal)
25
Causes of intrinsic hemolytic anemia
*Tissue hypoxia: PAIN
Sickle cell
Chronic fatal hereditary disease
Normal Hb replaced with Hb S
26
Treatment for intrinsic hemolytic anemia
Prevent sickle cell crisis
Opioids for tissue hypoxia
Hydrate pt
Prevent infections and treat them promptly
27
Why does polycythemia cause circulation impairment?
Increased volume and viscosity
28
What is primary polycythemia?
*Polycythemia Vera (have splenomegaly and hepatomegaly) that causes increase of RBC
29
What causes secondary polycythemia?
Too many RBC usually hypoxia driven
(High altitude, COPD, CHF)
30
S/S of polycythemia
Ruddy face and hands
HTN
*HCT >55
Pruritus
Splenomegaly
Paresthesias
31
major complications of polycythemia
Clots: CVA, MI, CHF
32
Treatment for polycythemia
Periodic phlebotomy (goal = <45%)
Hydration
Myelosuppression agents
*Low dose aspirin (*to help prevent clots due to slow moving blood)
Nursing indications:
- Strict I&O
- prevent thrombus formation
33
Symptoms of an infusion reaction
Febrile: sudden chills, fever, headache, flushing (reacting to donor’s WBC, making antibodies, most common)
Allergic: urticaria, dyspnea, anxiety, wheezing (reacting to donor blood)
Hemolytic: low back, chest, or flank pain Tachycardia, tachypnea (breaking up of RBC b/c of mismatched blood types)
34
Actions to take if pt is having a transfusion reaction
Stop blood
Maintain IV saline
35
What is an elevated BP?
120-129 and <80
36
What is HTN stage 1?
130-139 or 80-89
37
What is HTN stage 2?
>140 or >90
38
How does epinephrine influence BP?
Increases HR and contractibility = increased CO
39
How does norepinephrine influence BP?
Activates A1, A2, B1 & B2 & dopamine receptors
40
How does aldosterone influence BP?
Retains Na+ and water = raises blood volume & CO
41
How does ADH influence BP?
Increases ECF - reabsorbs water in kidneys and increases blood volume = increased CO & BP
42
Nonmodifiable risk factors for HTN
Age
Gender
Ethnicity
Family history
Socioeconomic status
43
Modifiable risk factors for HTN
Obesity
Sedentary lifestyle
Alcohol use
Tobacco use
Diabetes
Elevated serum lipids
Excess dietary sodium
Stress
Socioeconomic status
44
*Major organs affected by HTN
Heart (CAD, MI, LVH)
Brain (TIA, CVA, HTN encephalopathy)
PVD (aortic aneurysm, aortic dissection)
Kidney (CKD)
Eyes (damage to retina/arterioles)
45
Dietary recommendations for HTN
DASH diet
- Fruits, veggies
- fat- free or low-fat dairy
- whole grains
- fish, poultry, beans
- seeds and nuts
46
Sodium and alcohol intake recommendations for HTN
1500-2300 mg of salt/day
Men: 2 drinks/day. Women: 1 drink/day
47
Exercise recommendations for HTN
30 min x 5 days - goal of 150 min/week
With muscle-strengthening 2x/week
48
Classes of HTN drugs:
AAABCDD
ACEs
ARBs
Alpha 1 receptor blockers
Beta blockers
CCBs
Diuretics
Direct vasodilators
49
How do diuretics help HTN?
Promote urinary excretion of Na+ and water = lowers circulating blood volume
50
How to measure for orthostatic hypotension
Measure BP supine, sitting, and then standing with 1-2 min between position changes
Positive if:
- Decrease of 20 or more in SBP
- Decrease in 10 or more in DBP
- HR increase of 20 bpm or more
51
BP measurement for hypertensive crisis
>180 and/or >120
52
Causes of hypertensive crisis
Hx of HTN, non adherent or under medicated
Cocaine, amphetamines, PCP, LSD
- leading to seizures, CVA, encephalopathy or MI
53
Issues that cause target organ damage and need to be treated IMMEDIATELY
Encephalopathy
Intracranial or subarachnoid hemorrhage
HF, MI
Renal failure
Dissecting aortic aneurysm
Retinopathy
54
Symptoms of encephalopathy
HA, N/V, seizures, confusion, coma
55
Nonmidifiable risk factors for atherosclerosis
Age
Gender if <75 (> 75 y/o = equal risk)
Ethnicity (AA = > risk)
Family history
Genetic predisposition
56
Modifiable risk factors for atherosclerosis
Elevated serum lipids
Hypertension (>130/80)
Obesity (BMI >30)
Diabetes
Metabolic syndrome
57
Goal for cholesterol levels
<200 mg/dL
58
Goal for triglyceride level
Males <135
Females <160
59
Goal for LDL level
<130 mg/dL
60
Goal for HDL level
Female: >55
Male: >45
61
Parameters for metabolic syndrome
3 of the following:
1 - central obesity (women >35 in, men >40 in)
2 - fasting blood glucose >100 or prior T2DM Ex
3 - BP >130 / >85, or on drug tx
4 - triglycerides >150 mg/dL
5 - HDL <50 women, <40 men or on drug tx
62
What do you ask when a patient says they have chest pain?
PQRST:
Precipitating events
Quality of pain
Radiation of pain
Severity of pain (pain scale)
Timing (how long does it last, how often?)
63
Difference between stable and unstable angina
Stable - intermittent CP with exertion in familiar pattern (same pattern of onset, duration, and intensity)
Unstable - new onset, occurs at rest, lasts >15 min
64
What is prinzmetal’s angina?
*Spasm of major coronary artery
65
What is silent ischemia
No symptoms, associated with diabetic neuropathy
66
What should you teach pts with chronic stable angina?
Stop activity
Rest
Nitroglycerin (take 1 wait 5 min - up to 3 doses)
If pain still there after 15 min, call 911
And chew 2-4 baby aspirin
67
Nursing goals for chronic stable angina
Reduce O2 demand and/or increase O2 supply to:
*Optimize myocardial perfusion
- relieve pain
Immediate and appropriate treatment
Preservation of heart muscle if MI is suspected
68
*Nursing actions for chronic stable angina
Position upright, apply O2
Assess: VS, heart and breath sounds
Continuous ECG monitor (telemetry)
- Sometimes 12 lead ECG
Troponin levels
Provide support and reduce anxiety
Pain relief - nitroglycerin, IV opioid if needed
Obtain labs - cardiac bio markers
Obtain chest x ray
69
What should troponin levels be without heart damage?
<0.03
70
What is coronary angiography? And what is it used for?
Cardiac catheterization to visualize blockages in arteries and diagnose
71
What is percutaneous coronary intervention?
Opens blockages and fixes them:
- balloon angioplasty
- stent
72
What cause unstable angina?
Partial occlusion of coronary artery:
- UA - may have ECG change; troponin normal
- NSTEMI - ECG changes w/o ST elevation; troponin elevated
Total occlusion of coronary artery:
- STEMI - ECG changes w/ ST elevation; troponin elevated
73
Atypical symptoms of MI or angina in women
Chest pain, but not always
Pain or pressure in lower chest, upper abdomen, or upper back
Fainting
Indigestion
Extreme fatigue
74
BP requirements for nitroglycerin
SBP >100
If <100, don’t give, need to call provider
75
What should you teach pt about nitroglycerin and knowing if it’s still working when they take it at home?
Should tingle when they place it under their tongue
76
What plays a major role in development of atherosclerosis?
*endothelial injury and inflammation
77
Tests for markers of widespread endothelial damage in CV disease
C-reactive protein (CRP) - serum
- *Nonspecific marker of inflammation
(Linked with unstable plaques and oxidation of LDL cholesterol)
Microalbuminuria
- urine test
78
Uses of beta blockers
HTN
HF
MI
79
Actions of beta blockers
- Block beta receptors in heart and peripheral blood vessels
- Decrease HR
- Decrease force of ventricular contraction
- Reduce release of renin from kidneys
80
Side effects of beta blockers
Bradycardia, heart block, hypotension, HF
Adverse effect on lipids
Bronchoconstriction if block Beta 2 receptors
81
Antiplatelet therapy used for CAD
Aspirin
Clopidogrel (plavix)
82
Actions of Antiplatelet therapy
Irreversibly inhibits platelet aggregation for life of platelets
83
Use of Antiplatelet therapy
Prevent arterial clots, MI, ischemic CVA
84
Side effects of Antiplatelet therapy
GI upset
Increases risk for GI bleed and hemorrhagic CVA
Effects last up to 7-10 days = d/c 1 week before surgery
85
What do beta blockers end in?
Lol
86
What do ACE inhibitors end in?
Pril
87
Uses of ACE inhibitors
HTN
HF
88
Actions of ACE inhibitors
- Block production / conversion of angiotensin I to angiotensin II
- Reduces Afterload through vasodilation
- Lipid neutral
89
Side effects of ACE inhibitors
Cough (bradykinin in lungs)
Hyperkalemia (avoid salt substitutes)
Angioedema
90
What do ARBs end in?
Sartan
91
Uses of ARBs?
HTN
HF
92
Actions of ARBs
- Block action of angiotensin II receptor sites
- Vasodilation and decrease in aldosterone
- Increases renal excretion of Na and water
- Lipid neutral
- Renal and cardioprotective in hypertensive diabetic pts
93
Side effects of ARBs
Cough
Hyperkalemia
Angioedema
94
Examples of calcium channel blockers that lower HR
Verapamil (Calan)
Diltiazem (Cardizem)
95
Actions of CCBs
- Prevent Ca++ (a vasoconstrictor) from entering cells
- Relax smooth muscle, causes vasodilation
- Blocks SA node and AV node conduction which decelerates HR
96
Side effects of CCBs
HF
Hypotension
Dyspnea
Weight gain
Edema of lower extremities
*Bradycardia
Dizziness
97
Example of CCB that does not effect HR
Amlodipine (Norvasc) = SE of high HR
98
What do alpha 1 receptor blockers end in?
Zosin
99
Action of alpha 1 receptor blockers
- Lower BP through vasodilation by decreasing peripheral vascular resistance (relaxes smooth muscle)
- Favorable effect on lipids
100
Side effects of Alpha 1 receptor blockers and nursing interventions
- Orthostatic dizziness/syncope
- *Also used in BPH
- *Watch for syncope with 1st dose = admin 1st dose at bedtime
101
What are statins used for?
Lowering lipids
102
Actions of statins
- Increases # of LDL receptors on hepatocytes to allow for more removal of LDL
- Lowers triglycerides and increases HDL cholesterol
103
Side effects of statins
Monitor for liver damage and myopathy
104
What is Niacin (Niaspan)?
A B vitamin used to lower lipids
105
Action of Niacin (Niaspan)
Lower triglycerides and increase HDL (not to same degree as statins)
106
Side effects of Niacin
*Flushing
Pruritus
GI side effects
Orthostatic hypotension
Hepatoxic
107
What is fenofibrate (Tricor) used for?
Best at lowering triglycerides and increasing HDL
108
Side effects of fenofibrate (Tricor)
GI complaints (b/c works through GI tract)
109
What is Ezetimibe (Zetia)?
Bile acid sequestrant used to decrease cholesterol absorption in small intestine (GI complaints)
110
Definition of heart failure
Clinical syndrome with current or prior S/S caused by a structural/functional cardiac abnormality
With at least one of the following:
- Elevated Natriuretic peptide levels (BNP)
- Symptoms of congestion
111
Classification of Heart Failure by Ejection Fraction
HF with reduced EF: LVEF <40%
HF with preserved EF: LVEF >50%
112
How is HF classified?
Based on how the pt can function in their life
113
Symptoms of left sided heart failure
Fatigue, anxiety, weakness
Restlessness, acute confusion
S3, S4 heart sounds
Pulses alterans (weak, strong)
Angina, palpitations, tachycardia
Dyspnea (orthopnea, exertional dyspnea, PND)
Dry, hacking cough
Crackles or wheezes
Frothy, pink-tinged sputum
Oliguria/Nocturia
114
Symptoms of right sided heart failure
Fatigue, anxiety
Tachycardia
JVD
Weight gain (most reliable indicator of fluid gain/loss)
GI bloating
Nausea, anorexia
Ascites
Hepatomegaly
Spleenomegaly
Edema - pedal, scrotal, sacrum
115
What is HFrEF?
Left sided heart failure with reduced EF (systolic failure)
Inability to pump blood effectively
116
What is HFpEF?
Left sided heart failure with preserved EF (diastolic failure)
LV is stiff/noncompliant
Ventricles do not relax during filling
117
What are the counterregulatory mechanisms for heart failure?
Natriuretic peptides:
- ANP (atrial natriuretic peptide)
- BNP (b-type natriuretic peptide)
118
What do the natriuretic peptides do to counter-regulate heart failure?
Made and released by heart muscle in response to increased blood volume in heart
- Lead to: diuresis, vasodilation, and lower BP
(counteract effects of SNS and RAAS)
119
Impaired gas exchange due to HF is related to:
Alveolar-capillary perfusion changes
120
Nursing actions for impaired gas exchange with HF
Assess RR and work of breathing
Auscultate lung sounds q4hr
Monitor ABGs
O2 therapy (keep O2 sat >92)
Administer IV morphine sulfate
Semi-fowlers position
121
What is impaired cardiac output from heart failure related to?
Altered SV (contractibility, preload, Afterload)
122
Nursing interventions for impaired cardiac output with heart failure
Monitor AP, BP, pulses, lung and heart sounds, JVD, UOP, weight, and ECG (telemetry)
ACE inhibitors to reduce Afterload (elevated pressure in vessels)
Digoxin (Lanoxin) to increase contractility
Sodium restricted diet (to reduce preload)
Diuretics (to reduce preload)
123
Fluid imbalance with HF is related to:
Retention of sodium and water
124
Nursing interventions for fluid imbalance from heart failure
Ensure patent IV
Administer rapid acting diuretics
Fluid restriction if severe
Monitor for hypokalemia and treat
Limit to 1500-2300 mg sodium intake
*Weigh daily
Monitor I&O (Strict and accurate) *Report if <30 mL/hr
Monitor serum sodium and potassium
125
What is activity intolerance from heart failure related to?
Imbalance between O2 supply and demand secondary to cardiac insufficiency and pulmonary congestion
126
nursing actions for activity intolerance from HF
Alternate rest with activity
Monitor response to activity
Collaborate with OT/PT
Reduce anxiety
Evaluate support system
Patient teaching:
- energy conserving behaviors
- increase gradually
- avoid extreme heat and cold
- rest after exertion
- exercise training (cardiac rehab)
127
What do diuretics do for pts with HF?
Reduce edema, pulmonary venous pressure, and preload
Promote Na+ and water excretion (loop and thiazide)
Monitor potassium levels (*hypokalemia)
128
Type of diuretic and Action of furosemide (lasix)
Loop diuretic
Blocks Na+ and water reabsorption in loop of Henle
Decreases preload and pulmonary congestion
129
Side effects of furosemide (Lasix)
Excessive urination & dehydration
Hypokalemia, hyponatremia
Ototoxicity (transient deafness) *with rapid IV admin
Orthostatic hypotension
130
Push rate for furosemide (Lasix)
10-20 mg/min
131
Type of diuretic and action of hydrochlorothiazide (HydroDIURIL)
Thiazide
Blocks Na, Cl, and water reabsorption in distal convoluted tubule
132
Side effects of hydrochlorothiazide (HydroDIURIL)
Orthostatic hypotension
Hypokalemia
Hyponatremia
133
Type of diuretic and action of spironolactone (Aldactone)
Aldosterone antagonist
Block sodium-potassium exchange mechanism in distal tubule - prevents reabsorption and *Retains potassium
134
Side effects of spironolactone (Aldactone)
Hyperkalemia
135
Nursing actions for spironolactone (Aldactone)
Monitor and report weight gain
Avoid salt substitutes and foods high in K+
136
Routes for administering potassium chloride?
Oral
IVPB
**NEVER IVP
(*IV infusion rate not to exceed 10 mE/hr)
137
Side effects of potassium chloride
Hyperkalemia
GI - abdominal discomfort, N/V, diarrhea
138
What class does digoxin (Lanoxin) belong to?
Cardiac glycosides
139
Actions of digoxin (Lanoxin)
- Increases contractility and CO (*INOTROPIC effect)
- Decreases AV contraction (chronotropic effect) which decreases HR
140
Nursing actions for giving digoxin (Lanoxin)
*Take apical HR for 1 minute before administering
* If HR <60 or >120, withhold (instruct pt hot to take their own pulse)
- Monitor for therapeutic levels = *0.5-2.0 ng/mL
- Teach pt to report S/S of toxicity and hypokalemia
141
Symptoms of digitalis toxicity
GI symptoms: N/V, anorexia
Cardiac: palpitations, irregular pulse
Visual changes: blurred vision, halos or rings of light around objects
Neurologic: HA
142
What is heparin used for?
Anticoagulant
Used for risk for and actual DVT/VTE
143
Antidote for heparin
Protamine sulfate
144
Nursing actions for heparin
Monitor for HIT
APTT or PTT blood test q6hrs
Normal range = 30-40 sec, **want therapeutic: 1.5-2 times the normal range
145
What is Enoxaparin (Lovenox)?
Low Molecular Weight Heparin
146
Nursing actions for LMWH
No monitoring required
SC in abdomen = best place to administer
147
Action of Warfarin (Coumadin)
Inhibits synthesis of vitamin K clotting factors
(Slow onset: about 72 hrs)
** Prevents clot formation or extension, but *Has no effect on existing clots
148
Antidote for warfarin
Vitamin k
149
Nursing actions for warfarin
*PT and INR blood tests
Pt takes for 3-6 months
*Teach pt to maintain consistent intake of foods high in vitamin k, do not eliminate them
150
Oral anticoagulants
Dabigatran (Pradaxa)
Apixaban (Elliquis)
Rivaroxiban (Xarelto)
151
Pt teaching for oral anticoagulants
S/S of bleeding
Tell all providers on anticoagulant
Avoid ASA containing drugs
Use electric razor
Medic alert bracelet
Don’t massage injection sites
152
Conservative teaching for varicose veins
Elevation - rest with limb > heart
Elastic - compression stockings
Exercises - leg-strengthening
Weight loss
153
Classic symptoms of PAD
1- *Intermittent claudication (Pain)
2- Paresthesia in toes/feet
3 - Paralysis
Thin, shiny, dry, scaly, taut skin, thick toenails
Loss of hair on lower legs
4- Diminished or absent lower Pulses
5 - Elevation Pallor, dependent rubor
Muscle atrophy
6- Cold extremity
Pain at rest as disease progresses
154
*Drug therapy for PAD
Aspirin
Clopidogrel (Plavix)
Statins
155
Drug therapy for intermittent claudication
*Cilostazol (Pletal)
156
Function of Cilostazol (Pletal)
For intermittent claudication
- Inhibits platelet aggregation
- Increases vasodilation and blood flow
- Decreases pain
157
Side effects of Cilostazol (Pletal)
HA
GI S/S
158
Complications of PAD
Atrophy of skin and underlying muscles
Delayed wound healing
Wound infection
*Critical limb ischemia (stages 3 & 4)
159
What is critical limb ischemia?
Chronic ischemic leg pain at rest
Tissue necrosis
Arterial ulcers
160
Most serious complications of PAD
No healing arterial ulcers
Gangrene
May result in amputation!
161
What is acute arterial occlusion?
What causes it?
An emergency!
Sudden occlusion of an artery D/T:
- Post-op vascular surgery (thrombus)
- A fib, heart valve disease, or infection (embolic)
162
How to assess for acute arterial occlusion? and how to diagnose
Assess 6 P’s
- Pain
- Paralysis
- Pulses
- Perishingly cold
- Pallor
- Paresthesia
To diagnose: look at clinical presentation, echocardiogram, arteriogram
163
Treatment for acute arterial occlusion
Early intervention is essential to saving affected limb (*within 6-8 hrs)
Thrombectomy
Anticoagulant therapy
Thrombolytic therapy
Tissue plasmin activator (TPA) IV infusion
Long term anticoagulation if at increased risk for another embolism
164
What is compartment syndrome?
Big symptom = Pain that is out of proportion
Caused by pain and swelling in compartment that causes pressure on nerves and vessels
165
What is buerger’s disease?
Inflammatory disorder that results in clotting/thrombus formation (acute phase) and tissue ischemia/fibrosis (chronic phase)
166
Risk factors for buerger’s disease
Smoking/marijuana use
Males 20-45 yrs
167
Assessment for buerger’s disease
Pain (claudication) in foot arch
Reddish blue color
Absent distal pulses
Ulceration
Gangrene
168
What causes raynauds?
Vasospastic in small cutaneous arteries of extremities with intermittent, localized vasoconstriction
169
Post-op nursing actions for vascular procedure or surgery
Frequently monitor NV checks and vitals
Monitor for potential complications:
*Graft occlusion (emergency) = acute arterial occlusion. Treatment = thrombectomy
*Compartment syndrome. Treatment = faciotomy
170
Treatment for a leg with critical limb ischemia
Bypass surgery
171
Non-modifiable risk factors for stroke
Age *Risk doubles each decade after 55
Gender (more common in men, more women die)
Ethnicity/race (AA)
Heredity/family history
172
Modifiable risk factors for stroke
*HTN
*Smoking
Obesity
*Atrial fibrillation
*Diabetes
*Drug and alcohol abuse
Lack of exercise
Poor diet
Heart disease
Serum cholesterol
Sleep apnea
Metabolic syndrome
173
Types of medications use to prevent CVAs
Antiplatelet meds
Antiplatelet agents
Cholesterol meds
174
Interventions for CVA prevention
Can clip or coil aneurysms
175
Major types of strokes
Thrombotic stroke (caused by atherosclerosis)
Embolic stroke (clot has brakes off & moves to cerebral artery)
Hemorrhagic stroke (injured vessel, aneurism, arterio/venous malformation from birth, etc.)
176
How can you determine whether someone is having an ischemic vs. hemorrhagic stroke?
CT scan
*Need to know when their symptoms started
177
Where do most ischemic strokes occur?
Middle cerebral artery
178
What is a transient ischemic attack?
*Transient neurologic dysfunction with same S/S as CVA *caused by brief interruption of blood flow without infarction of brain
Occurs before a thrombotic stroke
179
How long does a transient ischemic attack typically last? And what is the common cause?
< 1 hr
Carotid stenosis
180
Which side of brain? Difficulty with language/ articulating words
Left
181
Which side of brain? Difficulty comprehending language
Left
182
Which side of brain? Short attention span/impulsive
Right
183
Which side of brain? Difficulty with spatial/perceptual ability
Right
184
Which side of brain? Difficulty with concept of time
Right
185
Which side of brain? Prone to anxiety and depression
Left
186
Which side of brain? Cautious/carries out tasks slowly
Left
187
What is receptive aphasia?
Loss of comprehension (Wernicke/sensory)
188
What is expressive aphasia?
Loss of production of language
(Brock/motor)
