recovering form stroke the early stages

Question 1

what age group are most people who suffer from a stroke

Answer 1

65 years or older

Question 2

Do most people become disabled after a stroke

Answer 2

No only 35%

65% live independently after a stroke.

Question 3

how long does recover from a stroke take

Answer 3

years after stroke.

Question 4

what are the clinical symptoms found in a stroke patient

Answer 4

ipsilateral body function loss- one side of face droops and same side the body cannot be moved.
expressive aphasia
homonymous hemianopia- visual field defect in the opposite eye.

Question 5

what part of the brain does the ACA supply

Answer 5

medial and anterior surfaces.

Question 6

what part of the brain does the MCA supply

Answer 6

lateral surface- motor and sensory cortex

Question 7

what part of the brain does the PCA supply

Answer 7

medial and lateral posterior surface

Question 8

Is weakness caused by a stroke on the contralateral or ipsilateral side

Answer 8

contralateral due to damage of the motor cortex.

Question 9

what are the consequences of weakness and incoordination of oropharyngeal muscles

Answer 9

Dysarthria: slurred, indistinct speech

Incoordination of swallowing

Question 10

which language areas are affected in stroke

Answer 10

broca’s and wernicke’s of the opposite side

Question 11

what type of aphasia does damage to broca’s cause

Answer 11

expressive.

Difficulty finding words but comprehension is fine.

Question 12

in which lobe is broca’s

Answer 12

lateral frontal lobe.

Question 13

what type of aphasia does damage to wernicke’s cause

Answer 13

receptive apahsia
Flow of speech is fluent
Neologism- made up words
Mistake closely related words
Comprehension, reading and writing is impaired.

Question 14

in which lobe in wernicke’s

Answer 14

posterior superior temporal lobe.

Question 15

define neologism

Answer 15

made up words.

Question 16

what happens to blood pressure immedialtey after a stroke

Answer 16

rises

Question 17

what happens to blood pressure a few days after a stroke

Answer 17

It settles down

Question 18

Antihypertensive treatment is not given after stroke unless.

Answer 18

Intracerebral haemorrhage with systolic BP >200,
Hypertensive encephalopathy/ nephropathy/ cardiomyopathy
Aortic dissection
Eclampsia/ pre-eclampsia

Question 19

what must the oxygen saturation be below for an individual to be on gas

Answer 19

95%

Question 20

how is capillary blood glucose checked

Answer 20

finger prick test

Question 21

how is diabetes confirmed

Answer 21

checking fasting venous blood glucose

Aim to control blood glucose between 4-11mmol/

Question 22

what does the acroymn SMART stand for which is used in stroke patient rehabilitiation

Answer 22

Specific, Measurable, Achievable, Relevant, Time-limited

Question 23

how many days within admission should the SMART goals be set

Answer 23

5 days

Question 24

what is the assessment for swallowing

Answer 24

patient is given teaspoon of water at a time and if they patient drools then they are said to be nil by mouth
If they consume 50 ml of water then there is no problem

Question 25

what are the clinical signs of aspiration pneumonia

Answer 25

``` Acutely short of breath and confused Respiratory rate high Temperature high Heart rate high Blood pressure low ```

Question 26

what are the preventative measures of DVT

Answer 26

LMWH

Question 27

what is the treatment for DVT

Answer 27

Warfarin

Question 28

what are the risk factors of DVT

Answer 28

immobility and sepsis

Question 29

What are the risk factors of pressure sores

Answer 29

Immobility, malnutrition, diabetes, smoking, terminal illness, sensory impairment

Question 30

pathogenesis of pressure sores

Answer 30

Sustained pressure, often over bony prominence- only takes a few minutes before causes tissue ischemia- eventually causing tissue necrosis.

Question 31

what causes shoulder sub laxation post stroke

Answer 31

Neglect of affected limb in stroke

Question 32

management of shoulder sub laxation

Answer 32

optimises positioning and shoulder support

Question 33

define neuropathic pain

Answer 33

Pain down entire right side: arm and leg Burning, tingling Present since 2 or 3 days after stroke, but getting worse Not much benefit from paracetamol and ibuprofen he is taking for his shoulder and knee.

Question 34

define negative phenomana

Answer 34

Decreased sensation in one or more modalities

Question 35

define positive phenomena:

Answer 35

Paraesthesia, burning, shooting pains | Dysaesthesia: altered perception (e.g. soft touch felt as prickly pain

Question 36

what medication is used to treat post stroke pain

Answer 36

Pregabalin or Gabapentin: anti-epileptic agents | Amitriptyline: a type of antidepressant- causes drowsiness

Question 37

why must bladder incontinence be managed

Answer 37

can’t tell staff when he need to go due to lack of communication. Inability to access nurse call buzzer: hemi sensory neglect. Immobility: can’t reach toilet in time Constipation with overflow Medication: on laxatives, diuretics

Question 38

how is a patient tested for depression

Answer 38

History Observation of behaviour: crying, withdrawal Standardised assessments: some suitable for use in dysphasic patients

Question 39

management of depression

Answer 39

Counselling: supported conversation approach Drugs: (selective serotonin reuptake inhibitors) second line

Question 40

what are the common health problems which arise post-MI

Answer 40

``` hypertension DVT Shoulder sub laxation speech difficulty movement difficulty- sub laxation of the shoulder aspiration pneumonia bed/ pressure sores. ```