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N232 > Module 7 Part 1: CVA > Flashcards

Module 7 Part 1: CVA Flashcards

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1
Q

what is a CVA?

A

occurs when blood flow to the brain is interrupted by a blocked or busted blood vessels

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2
Q

what is a CVA d/t blocked vessels called?

A

ischemic

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3
Q

what percentage of strokes are ischemic?

A

80%

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4
Q

what is a CVA d/t a burst vessel?

A

hemmorhagic

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5
Q

what percentage of strokes are hemmhoragic?

A

20%

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6
Q

what determines the extent of brain function and thus the severity of the stroke?

A

the duration, severity, and location of the cerebral ischemia

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7
Q

what are the non-modifiable risk factors of a CVA?

A

male, age, race

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8
Q

what are modifiable risk factors of a CVA?

A

HTN, Afib, hyperlipidemia, obesity, smoking, diabetes, periodontal disease

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9
Q

if the stroke is on the left side of the brain what side of the body will be affected?

A

the right!

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10
Q

what are causes of ischemic strokes?

A
  • large artery thrombotic
  • small penetrating artery thrombotic
  • cardiogenic embolic (A fib pts)
  • crytogenic (no known cause)
  • cocaine use
  • migraines
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11
Q

what is the number one cause of hemorrhagic strokes? why?

A

HTN (causes aneurysm to burst)

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12
Q

what is a TIA?

A
  • transient ischemic attacks

- like angina

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13
Q

do TIAs cause permanent damage?

A

no

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14
Q

how does a TIA present?

A

as a stroke, but then completely reverses

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15
Q

what is the acronym for signs of a stroke?

A

FAST

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16
Q

what motor function is lost in a CVA?

A
  • hemiplegia
  • hemiparesis
  • ataxia
  • dysphagia
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17
Q

what is hemiplegia?

A

paralysis of one side of body

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18
Q

what is hemiparesis?

A

weakness of face, arm or leg d/t lesion on other side of brain

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19
Q

what is ataxia?

A

unsteady gait

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20
Q

what is dysphagia?

A

difficulty swallowing

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21
Q

what are the communication losses present in a CVA?

A
  • dysarthria
  • dysphasia
  • aphasia
  • apraxia
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22
Q

what is dysarthria?

A

difficulty speaking caused my paralysis of muscles with speech

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23
Q

what is dysphagia?

A

difficulty/loss of speech

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24
Q

what is aphasia?

25
what is apraxia?
inability to preform previously learned skills
26
what are the perceptual changes in a patient with a CVA?
- visual perceptual dysfunctions d/t disturbances of the primary sensory pathways between the eye and visual cortex - homonymous hemianopsia (loss of half of field of vision)
27
is homonymous hemianopsia permanent?
it can be, not always
28
what are sensory losses associated with CVA?
- touch impairment | - difficulty interpreting stimuli
29
what are cognitive impairments of CVAs?
- frontal lobe damage - limited attention span - comprehension difficulty - forgetfulness - apathy
30
what does frontal lobe damage cause?
loss in learning capacity, memory, and other higher intellectual functions
31
what are the emotional deficits with CVAs?
- loss of social filters (eg. clothes off in public) - loss of self-control - emotional lability - withdrawal - fear, hostility, anger - feelings of isolation
32
what do CT scans show with CVAs?
whether it is hemorrhagic or ischemic
33
what is the CT angiogram? and does it show?
punctures the patient's artery and feed the catheter and inject dye to see what vessel is occluded
34
what is a carotid ultrasound?
on the carotid artery to see if sufficient blood flow
35
would you use an MRI or CT first? why?
TIME IS TISSUE! | - the CT is faster
36
when do you give rtPA (thrombolytic)?
within 4.5 hours | 1.5 hours LONGER than what we learned in patho... how annoying
37
what patients can you give tPA to?
- normal CT scan - BP <180/100 - no bleeding tendancy
38
what is the does of tPA you can give?
0. 9mg/kg (max 90mg) | - 10% bolus, rest 60 mins by infusion
39
what is the risk of giving a tPA?
intracranial haemorrhage (6% of patients)
40
what are other pharm interventions for CVA?
- thrombolytic - antihypertensives - anticoagulant - platelet inhibiting medications - anticonvulsant
41
what are some nursing care for after a TPA?
- rest - oxygen - IV access - watch for signs of bleeding - neurovitals & BP frequently - inc. HOB - blood glucose monitoring - monitor/manage fever
42
do all patients suffer shoulder pain post CVA?
no, only 70%
43
what is nursing care for shoulder pain?
proper positioning of weak arm/shoulder and support from pillows ESPECIALLY with paralysis
44
how do nurses care for the nutrition of CVA patients?
- dysphagia - difficulty swallowing | - at risk for aspiration pneumonia
45
how to reduce risk of aspiration pneumonia?
- HOB 30 degrees | - feeding tubes
46
what area of the brain is in charge of understanding speech?
Brocca's area
47
what do nurses need to assess with skin?
tissue breakdown d/t altered sensation and pressure | - special beds, regular turning and poisitoning
48
how often should you reposition a patient?
Q2h
49
nursing care for the bladder post CVA?
intermittent catheterization, atonic bladder
50
nursing care for bowels post CVA?
constipation d/t dec. mobility - fibre foods, medications
51
what are the S&S of an ischemic stroke?
- numbness - weakness of face, arm or leg - especially one side of body
52
how long is the usual functional recovery from an ischemic stroke?
usually plateaus at 6 months
53
what are the causes of hemorrhagic strokes?
- intercerebral hem - subarachnoid hem - cerebral aneurysm - arteriovenous malformation
54
what are the S&S of a hemorrhagic stroke?
- "exploding headache" | - dec. LOC
55
how long is the usual functional recovery for hemorrhagic strokes?
slower usually, plateaus at about 18 months
56
what do clinical manifestations depend on?
- the location of the lesion - the size of the area of inadequate perfusion - the amount of collateral blood flow
57
how much does the brain age each hour without treatment following a CVA?
3.6 years
58
what are the medications called that protect the brain from secondary injury? wha do they do?
neuroprotectants | - help improve cellular environment
59
how long does a TIA usually last?
less than 1 hour

N232 (9 decks)

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