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NUR 103A > PT2 - Neuro - Stroke > Flashcards

PT2 - Neuro - Stroke Flashcards

(48 cards)

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1
Q

Types of stroke

A

Ischemia = clots
Thrombotic = blood clot in cereberal artery
Embolic = blood clot from another part of body that travels to the cerebral artery

Hemorrhagic = ruptured artery or aneurysm (blood touches the brain)

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2
Q

Risk factors of stroke

A

HTN
Smoking
Diabetes
A-fib
Hyperlipidemia
Previous TIA

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3
Q

What is a TIA?

A

Temporary blockage of blood flow to the brain.

Symptoms last a few minutes up to 24 hours

May precede a stroke (CVA)

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4
Q

Diagnostics for stroke

A

CT
MRI
Cerebral angiogram

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5
Q

Treatment of Ischemic Stroke

A

TPA - Alteplase - Thrombolytics (w/in 4.5 hours of onset of symptoms of stroke) if longer or unknown - do not give

Anticoagulants
Antiplatelets
Surgical aneurysm repair

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6
Q

Collateral Blood flow is fail safe mechanism - in stroke - called

A

the Circle of Willis

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7
Q

What is the most effective way to decrease burden of stroke is…

A

prevention and teaching

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8
Q

How does gender affect stroke risk factors?

A

more common in men

more women die and most likely to have hemorrhagic stroke

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9
Q

How does ethnicity affect stroke risk factors?

A

higher incidence and death rates in blacks

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10
Q

What are modifiable risk factors for stroke?

A
  1. HTN
  2. Heart disease
  3. Diabetes
  4. cholesterol
  5. smoking
  6. obesity
  7. sleep apnea
  8. metabolic syndrome
  9. lack of physical activity
  10. poor diet
  11. alcohol and drug use
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11
Q

TIA does not have what to the brain?

A

W/O acute infarction of brain

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12
Q

How long does a TIA last?

A

less than an hour

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13
Q

OUTCOME of TIA?

A

no way to predict outcome:

1/3 do not have another event
1/3 have no more TIAs
1/3 progress to stroke

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14
Q

Can you distinguish TIA and Stroke when happening?

A

NO

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15
Q

Thrombotic stroke =

A

narrowing - plaque

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16
Q

Embolic stroke =

A

clot floats of and travels to the brain

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17
Q

Types of Hemorrhagic stroke?

A

Intracerebral

Subarachnoid

blood vessels rupture

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18
Q

Definition of ischemic stroke

A

inadequate blood flow to brain from partial or complete occlusion of an artery

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19
Q

Penumbra

A

penumbra refers to the area of the brain that is at risk but not yet dead during a stroke (especially an ischemic stroke).

presence of collateral circulation (Willis)

Time sensitive

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20
Q

Most common cause of hemorrhagic - intracerebral hemorrhage

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A

Uncontrolled HTN

21
Q

Other causes of Hemorrhagic stroke

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A

HTN
vascular malformation
coag disorders
anticoag drugs
trauma
brain tumors
ruptured aneurysms

22
Q

What is a SUDDEN headache - worst ever?

Study These Flashcards
A

hemorrhagic stroke

23
Q

Intracerebral Heorrhage manifestations

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A

neuro deficits
headache
N/V
decreased LOC
HTN

24
Q

Cerebral aneurysim

Study These Flashcards
A

in Circle of Willis

Silent Killer

25
Subarachnoid hemorrhage
intracranial bleeding into CSF Caused by rupture of cerebral aneurysm, trauma, illicit drugs
26
Most obvious effect of stroke?
Speech
27
Motor functions of stroke - S/S
Speech Swallowing mobility Respiratory function Gag reflex - aspiration Self-care deficits muscle - tone, voluntary movement, reflexes NPO until swallow eval
28
Clinical manifestations affecting communication
Aphasia Dysphasia Dysarthria Pronunciation articulation phonation tip top ship shape fifty fifty
29
Dysphasia
impaired ability to communicate motor involvement slurring speech
30
different types of aphasia
Receptive = don't understand Expressive = cannot respond (express) with correct words. -- word salad Global = have both issues - total loss of ability to communicate
31
Dysarthria
problem with muscular control of speech
32
Diagnostic of Stroke
Confirm is a stroke Identify the likely cause stroke (throbo or embolic - MRI) Start with noncontrast CT scan or MRI CTA or MRA cerebral angiogram digital subtraction angiography transcranial doppler ultrasound lumbar puncture
33
GOLD standard stroke event
MRI
34
CT is faster than MRI what to do if you have a contrast allergy
get MRI
35
What are you looking for in a lumbar puncture?
blood in lumbar region after it drained from brain takes 1-2 days subarachnoid bleed = back pain, head pain
36
Most common antiplatelet med at risk for stroke
81 mg/day - aspirin Also statin - stabilize plaque blood thinners =warfarin
37
What drugs are used for TIA patients
Antiplatelet drugs
38
Surgical procedures for stroke TIAs - due to carotid tissue
Carotid endarterectomy - scrape out transluminal angioplasty Brain stenting Thromboectomy - large clots
39
POSTOP care sx therapy
NEURO assessment - NIH BP mgmt assess for complications stent occlusion retroperitoneal hemorrhage = lower backside bruising/bleeding minimize risk of bleeding at insertion site - fem stop (used to be sandbags)
40
Acute care of ischemic stroke: GOALS
preserve life prevent further damage reduce disability
41
Acute care of ischemic stroke: time...
time of onset of symptoms critical information!!! manage ABCs
42
Permissible HTN for stroke for protective measures
,180/85 protective measure = perfusion to brain
43
Drug therapy for acute ischemic stroke
tPA = atelplase (w/in 4.5 hours) carefully screen - bleeding active no give
44
After patient has stabilized and to prevent further clot formation stroke caused by thrombi/emboli treated further with:
anticoagulants platelet inhibitors statin = ischemic stroke Aspirin ticlopidine clopidogrel dipyridamole
45
Manage hemorrhagic stroke priorities
ABCs and intracranial pressure (HOB 30)
46
surgical interventions for hemorrhagic stroke
1. evacuation of hematomas - remove clot 2. resection or radiosurgery 3. clipping or coiling of aneurysm - chosen based in cause of stroke
47
BP for hemorrhagic stroke
manage by calcium channel blockers narcardopine
48
After stroke patient is at risk for
VTE use SCDs Aspirin Levonax

NUR 103A (8 decks)

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