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Foundations 1 > Stroke > Flashcards

Stroke Flashcards

(42 cards)

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1
Q

Who has higher incidence for stroke

A 
atherosclerosis, diabetes, HTN, obesity
American Indians
Alaskan Natives
First degree relative
Southeastern United States (40% higher mortality rate)
Relative who had stroke
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2
Q

transient ischemic attack (TIA)

A

temporary interruption in the blood supply to the brain

  • precursor for something very bad that is going to occur
  • go away anywhere from 30 mins to 24 hours
  • may be able to see on the scan
  • need to intervene before it comes a serious issue
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3
Q

transient Ischemic Attack

Visual deficits

A

Blurred or double vision
Blindness or tunnel vision
Change in visual field

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4
Q

Transient Ischemic Attack

motor deficits

A

Weakness and ataxia
Gait changes
Cant move an extremity

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5
Q

Transient Ischemic Attack

Speech deficits

A

Aphasias or dysarthrias(slurred speech)

Difficulty speaking

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6
Q

Transient Ischemic Attack

Sensory perception deficits

A

Numbness and vertigo

Paralysis

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7
Q

Neurological Assessment

A

Level of consciousness

Impaired cognition

Impaired sensory

NIH Stroke Scale

Glasgow Coma Scale

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8
Q

Cerebral Vascular Accident (CVA)

A

Interruption of normal blood supply (o2 and nutrients) to brain tissue.

  • medical emergency
  • causes ischemia: the tissue dies
  • brain doesn’t have glucose or energy stored to supply the brain if a loss of blood supply occurred, also needs to release the waste from the brain by releasing it through the veins, so this is why when blood flow is cut off for over a few mins, cerebral tissue is dying
  • need to do something immediately to stop the blockage to the brain
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9
Q

FAST recognition of stroke

A

Face-are both sides equal? is the smile smile equal?
Arms-can the clients raise both arms equally?
Speech-is speech slurred? can the client make a sentence?
Time-get help now, there is a small window of opportunity

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10
Q

Modifiable risk factors

A 
Lifestyle changes
weight management
diet
exercise
alcohol use
smoking
obesity
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11
Q

nonmodifiable risk factors

A

Age(after age 55, risk doubles each 10 years)
family history
ethnicity
history of previous stroke

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12
Q

Thrombotic Strokes

onset, duration

A
  • Onset: caused by a thrombus, little over half the strokes that occur, it is usually a gradual progression, symptoms occur slowly over time
  • Duration: improvements over weeks to months; permanent deficits possible
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13
Q

Contributing factors to thrombotic strokes

A

Contributing factors: atherosclerosis in a blood vessel within the brain, usually carotid, fatty plaque slowly develops, it may rupture, and then the body will send cells and fluid to try to fix the rupture and it will occlude the blood vessel

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14
Q

Embolic Strokes onset and duration

A

Onset: very sudden
Duration: rapid improvements

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15
Q

Embolic Strokes-Contributing factors

A

Contributing factors: clots that travel from somewhere else, cardiac issues, HA, a fib, emboli are then traveling to the arteries in the brain

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16
Q

Hemorrhagic Strokes-onset, prodromal symptoms, neurological deficits

A

Onset: could occur very rapidly
Prodromal symptoms: edema, irritation to tissues,
Neurological deficits: intracranial pressure, HA, sudden deficit

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17
Q

Hemorrhagic Strokes

Contributing factors

Study These Flashcards
A

Contributing factors: blood vessel wall breaks open and bleeds into the brain, HTN, a lot of the ppl that survive this stroke are much younger, could be due to substance abuse such as cocaine-increases BP quickly, aneurysm rupturing could cause cerebral breathing

18
Q

Emergent Care Treatment

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A

Fibrinolytic therapy (tPA)-when there is a blockage, this drug can break up the clot, have to qualify to get this drug(usually if had surgery or have risk for bleeding)

Endovascular interventions-may go in and actually remove plaque from the carotids, if they think that’s where its coming from

19
Q

Aphasia
what is it?
Two types?

Study These Flashcards
A

inability to speak or comprehend language

Expressive: brocas area, signal coming in is fine, but getting the signal going back out doesn’t make sense

Receptive: somehow the signal into the brain cant be understood

20
Q

Dysphasia

Study These Flashcards
A 
difficulty speech
(s=speech)
21
Q

Dysphagia

Study These Flashcards
A 
difficulty swallowing 
(g=GI)
22
Q

hemianopsia

Study These Flashcards
A

loss of half a visual field

23
Q

Homonymous hemianopsia

Study These Flashcards
A

lost same visual field in both eyes

  • brain not sending signals correctly
  • ppl may not know that they lost it
24
Q

Ataxia

Study These Flashcards
A

changes in gait and how they move

25
Apraxia
the person has difficulty carrying out sequential events or commanded movements -Ex: someone is walking across the room, upright, balance, coordination
26
Agnosia
inability to identify familiar objects by the use of senses
27
Unilateral inattention syndrome
interruption of blood supply and the brain just doesn't recognize the affected side, the brain literally doesn't think it exists, major safety issue, have to really try to maintain that side
28
Hemiplegia
paralysis of one side of the body
29
Hemiparesis
weakness on one side of the body
30
Left Sided CVA
Left side of their brain/right side of the body Right side hemiplegia Impaired speech / language and aphasias Slow performance-with simple tasks, may forget what they are doing in the middle of it Impaired comprehension related to language / math Awareness of deficits-they know what happened and what they cant do anymore, more likely to be depressed Emotional lability
31
Right sided CVA
Right side of the brain/left side of the body Left hemiplegia Spatial - perceptual defects -Depth perception, stairs, stepping, difficulty picking up things Impulsive Impaired judgment-overextend what they should be doing Denial-nothing wrong with me, don't need to be here
32
Pharmacological Interventions-anticoagulation
usually with embolic or thrombolic stroke, TIA, non break up the clot, just slowing the clotting cascade - asprin - plavix(clopidogel) - coumadin(warfarin)
33
aspirin
÷Action: non-steroidal anti-inflammatory, affects the cox inhibitor ÷Adverse effects: GI bleeding ÷Taking it: with something to eat, usually coated-to hold off release
34
Plavix (clopidogrel)
÷Action: stops platelet aggregation-makes them less sticky, also inhibits thrombus formation ÷Adverse effects: risk for bleeding
35
Coumadin (warfarin)
Action: stops the vitamin K sequence in the clotting cascade | ÷Adverse effects: vitamin K alter the affect, antibiotics make it more effective-have lab tests done, risk for bleeding
36
Nursing Diagnoses for a stroke patient
Risk for ineffective tissue perfusion (cerebral) Risk for aspiration Unilateral neglect (unilateral inattention) Self care deficit
37
Impaired mobility nursing interventions
* Baseline deficits * Passive ROM * Give assistive devices * Have them do as much as they can for themselves * Fall risk assessment * Home safety/fall risk * Reposition at least every 2 hours
38
Ineffective tissue perfusion nursing interventions
* lower HOB-Want them down, to get blood to reach their brain * Monitor BP, HR, SPO2 * SCD, ted hose to increase venous return * Neuro checks
39
Aspiration nursing interventions
•Have a swallow study done to assess gag reflex •LOC •ability to swallow •Bed at 90 degrees •Small bites-swallowing all food and not pocketing •Proper thickness of foods •Make sure they have fluids during the meal •Chin tuck •Don't talk while eating •Feed on their unaffected side •Risk for pneumonia-before and after check their lung sounds -Change in mental status, decreases SPO2
40
Impaired verbal communication nursing interventions
* Alternative forms to communicate * Slow talking and give them time to process * Limit distractions * Therapeutic touch/environment * Good eye contact and eye level * Short sentences * Yes/no questions
41
Unilateral neglect nursing interventions
•Fall precaution •Put needed things on the unaffected side -Call light, water •Encourage family participation •Affected side is in a safe position-they cant do it by themselves
42
Selfcare deficit nursing interventions
``` •4 kinds-bathing, dressing, toileting, feeding •Dressing -Use adaptive clothing-Velcro, -Involve pt in decision of what to wear -Give enough time -Dress affected side first ```

Foundations 1 (8 decks)

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