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Stroke Flashcards

(43 cards)

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1
Q

A stroke results in

A

Death of brain cells

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2
Q

How do you know a patient is having a stroke? What signs do you see?

A

“FAST”
- Face droops
- Arm weakness
- Speech difficulty
- Time is critical

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3
Q

What causes a stroke?

A

Disruption in the blood supply to part of the brain

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4
Q

What are strokes classified as?

A
  • Ischemic: inadequate blood flow to brain
  • Hemorrhagic: Bleeding into brain
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5
Q

What are the diagnostic tests for stroke?

A
  • CT 1st
  • MRI
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6
Q

Non modifiable risk factors for stroke

A
  • Age
  • Gender — more common in men
  • Ethnicity — higher in African Americans
  • Hereditary
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7
Q

Modifiable risk factors for stroke

A
  • HTN!
  • CV disease
  • Diabetes
  • Smoking, alcohol, drugs
  • Birth control pills/hormone replacement
  • Obesity
  • Sleep apnea
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8
Q

Types of Stroke

A
  • Transient Ischemic Attack (TIA)
  • Ischemic
  • Hemorrhagic
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9
Q

Transient ischemic attack (TIA)

A

Transient episode of neurologic dysfunction that serves as warning sign of further Cerebrovascular disease

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10
Q

Ischemic strokes are either

A

Thrombotic or Embolic

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11
Q

Define an ischemic stroke

A

Deprivation of oxygen to brain

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12
Q

Ischemic: Thrombotic Stroke

A
  • Occurs from injury to blood vessel wall & formation of a blood clot
  • Results from thrombosis or narrowing of blood vessel
  • Most common
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13
Q

Thrombotic strokes are associated with

A
  • DM and HTN
  • Can be preceded by a TIA
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14
Q

Ischemic: Embolic Stroke

A
  • Embolus dislodges & occludes a cerebral artery
  • Results in infarction and edema of area supplied by involved vessel
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15
Q

What do patients take when they have Embolic stroke?

A

Blood thinners

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16
Q

Embolic stroke mostly originates from

A

The endocardial layer of the heart

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17
Q

Embolic stroke ______ onset

A
  • Sudden onset with severe clinical manifestations
    -Pts usually remain conscious
  • Commonly recur
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18
Q

Hemorrhagic stroke results from

Study These Flashcards
A

Bleeding into
- brain tissue
- subarachnoid space or ventricles

19
Q

Intracerebral Hemorrhage

Study These Flashcards
A
  • Bleeding in brain caused by rupture of vessel
  • Sudden onset
  • Progression over minutes to hours because of ongoing bleeding
20
Q

Intracerebral hemorrhage prognosis

Study These Flashcards
A

Poor with a 30 day mortality rate of 40-80%

21
Q

Intracerebral hemorrhage most commonly caused by

22
Q

Intracerebral hemorrhage manifestations

Study These Flashcards
A
  • Neurological deficits
  • Headache
  • N/V
  • Decreased LOC
  • HTN
23
Q

Subarachnoid hemorrhage

Study These Flashcards
A

Intracranial bleeding into cerebrospinal fluid-filled space between arachnoid and pia mater

24
Q

Subarachnoid hemorrhage often caused by

Study These Flashcards
A

Rupture of cerebral aneurysm, trauma, or illicit drug use
- Incidence increases with age; higher in women
- Silent killer

25
Cerebral vasospasm
Administration of calcium channel blocker (Nimodipine)
26
Stroke on right side of brain
- Paralyzed left side : hemiplegia - Spatial perceptual deficits - Rapid performance, short attention span - Impulsive, safety problems - Impaired judgement and time concepts
27
Stroke on left side of brain
- Paralyzed right side - Impaired speech - Slow performance, cautious - Aware of deficits (anxiety and depression) - Impaired comprehension of language and math
28
Clinical manifestations of stroke
- Motor deficits - Communication deficits - Cognitive impairment - Psychological effects - Elimination
29
Motor deficits
- Hemiplegia: complete/severe loss of strength - Hemiparesis: mild loss of strength - Ataxia: poor muscle control
30
Communication
- Dysarthria: can’t form words - Dysphasia: affects ability to understand and use words - Aphasia
31
Cognitive impairment
- Memory loss - Decreased attention span - Poor reasoning - Altered judgement
32
Psychological effects
- Loss of self control - Depression - Emotional lability
33
Stroke on right side of brain is more likely to cause
- Problems in spatial perceptual orientation - Agnosia: loss of ability to identify objects or people - Apraxia: difficulty with skilled movements
34
What does a CT or MRI tell you?
Tells if the stroke is ischemic or hemorrhagic
35
Prevention
- Diet - Weight control - Exercise - No smoking - Limit alcohol - BP management!! Bc HTN
36
Prevention drug therapy
- Antiplatelet drugs used in pts who have had TIA - Aspirin (81mg/day) - Anticoagulation for pt w a fib - Warfarin - Statins, antihypertensives
37
Thrombolytic therapy within
3 hours of s/s
38
Surgical management for ischemic stroke
- Carotid endarterectomy - Carotid stenting
39
Surgical management for hemorrhagic stroke
- Aneurysm clipping, coiling - Resection of arteriovenous malformation
40
Nursing interventions for stroke
- Support resp. system - Frequent neuro exam - Monitor CV and musculoskeletal system - Monitor for skin breakdown and constipation - Promote normal bladder function - Nutritional status - Be supportive w communication - Initially arrange clients environment within perceptual field - Clear and understandable explanations
41
Achieve self care
- Encourage to assist in personal hygiene as soon as able to sit up - Start with affected side - Dressing — better balance when seated - Use larger clothing - Place on affected side — dress first
42
Attain bladder control
- Bladder retraining program - Offer urinal/bedpan on schedule - Avoid use of catheters - Upright posture and standing position for males
43
What medications can decrease a patients risk for stroke?
- Warfarin - Antiplatelet - Statin - Antihypertensive

IM4 (13 decks)

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