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Neuro Exam- Stroke
| Question | Answer |
|---|---|
| Disruption of the cerebral blood flow d/t an obstruction. | Ischemic Stroke aka Brain Attack or Cerebrovascular Accident (CVA) |
| Complex series of metabolic events which occurs in stroke | Ischemic Cascade |
| During ischemic cascade, large amount of ______ causes pH of blood, which causes _______ not to fx, which leads to ___________ and cells stop functioning. | Lactic acid, neurons, electrolyte imbalance |
| The _______ region is centered around the infarction can be salvaged with timely intervention at each step. | Penumbra |
| Ischemic brain ages _____ years each hour without treatment | 3.6 |
| Ischemia from diminished 02 results in | necrosis of brain tissue |
| Early treatment with _________ provides better outcomes, which is why knowing ________ is SO VITAL! | thrombolytics, when CVA began |
| Most common motor dysfunction with CVA | Hemiplegia |
| Paralysis of one side of the body | Hemiplegia |
| Weakness of one side of the body | Hemiparesis |
| Difficulty walking, unsteady gait, loss of balance or coordination | Ataxia |
| DTRs usually reappear after ___ hours along with spasticity, increased tone, on the affected side | 48 |
| Difficulty in speaking from paralysis of speech muscles | Dysarthia |
| Impaired speech | Dysphasia |
| Loss of speech | Aphasia |
| Broca's area affected. Inability to express oneself. | Expressive aphasia |
| Wernicke's are affected. Inability to understand language. | Receptive aphasia |
| Mixed type of aphasia | Global aphasia |
| Inability to perform a previously learned action. Seen when pt makes verbal substitutions for words. | Apraxia |
| The ability to interpret sensation | Perception |
| Visual-perception dysfunctions are problems between the eye and ________ | Visual cortex |
| Loss of half the visual field | Homonymous Hemianopsia |
| Problems with perceiving the relationship of 2 or more objects in spacial area are frequently seen in pts with _________hemispheric damage. | right |
| Sensory loss. Problem interpreting by sight, touch, or hearing. | Agnosia |
| If damage to the _________ lobe, learning capacity, memory, or other higher cortical intellectual functions impaired. | Frontal |
| Abrupt change in emotional behavior from crying to laughing. | Emotional incontinence |
| #1 Diagnostic test for CVA is _______ to R/O ______ | Non-contrast CT, Ischemic or hemorrhage stroke |
| What two tests, other than CT, used for Dx CVA | EKG (source of thrombus) and Carotid US |
| Temporary neuro s/s lasting less than 1 hour | TIA |
| Warning sign of stroke | TIA |
| Sudden loss of motor, sensory, and/or visual function | TIA |
| Primary major, modifiable risk factor for stroke | HTN |
| Three non-modifiable risk factors for stroke | Age (>55), Gender (M), and Race (AA) |
| Used ONLY for ischemic strokes | Thrombolytics |
| t-PA must be given within _______ of s/s onset | 3 hours |
| What is the max dose of t-PA? | 90 mg |
| t-PA is given ____mg/kg | 0.9 |
| #1 SE t-PA | Bleeding |
| t-PA eligibility requirements state person may not have heparin ___ hours prior and platelet count must be at least _______ or greater | 48 hours, 100,000 |
| t-PA eligibility requirements state person may not have major sx with ____ days, no stroke, head injury, or intracranial sx within ____ months | 14 days, 3 months |
| t-PA eligibility requirements state person must have a BP less than | 185/110 |
| Three assessment priorities | Airway, Cardiac, Neuro |
| Name three non-thrombolytic therapies | Anticoagulants, Anitplatelet, symptomactic treatment |
| Two Anticoagulant therapies and their labs | IV Heparin (aPTT) and IV Coumadin (INR, PT) |
| Position HOB at _____ and have _____ available to manage secretions. | 25-30, suction |
| ______ muscles are stronger than extensor | Flexor |
| Prevent shoulder ________ with correct positioning. | Adduction |
| Distal joints should be ________ than proximal. | Higher |
| What labs should we look at for nutrition? | Albumin and protein |
Created by:
mreedy
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