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DIC, SVD, CVA
| Question | Answer |
|---|---|
| not a disease but a sign of an underlying disorder; severity is variable; may be life threatening; triggers may include: sepsis, trauma, shock, cancer, abruptio placenta, toxins, and allergic reactions | Disseminated Intravascular Coagulation (DIC) |
| Altered hemostasis mechanism causes massive clotting in microcirculation. As clotting factors are consumed, bleeding occurs. Symptoms are related to tissue ischemia and bleeding. | Disseminated Intravascular Coagulation (DIC) |
| Tx: treat underlying cause, correct tissue ischemia, replace fluids and electrolytes (isotonic), maintain blood pressure, replace coagulation factors, use heparin | Disseminated Intravascular Coagulation (DIC) |
| med that is a blood thinner BUT has opposite effect in DIC? (preferred Tx in DIC) | heparin |
| lab tests for DIC? | Platelet count, PT/INR, aPTT, Fibronogen, D-dimer |
| T or F? Disseminated intravascular coagulation is not a disease but a sign of an underlying condition. | True |
| causes: -large artery thrombosis -small penetrating artery thrombosis -cardiogenic embolic -cryptogenic (no known cause) | ischemic stroke |
| Sx: numbness or weakness of face, arm, or leg, especially on one side (main Sx); confusion or change in MS; trouble speaking or understanding speech; difficulty walking, dizziness, or loss of balance; sudden/severe HA; perceptual disturbances | ischemic stroke |
| causes: -intracerebral hemorrhage -subarachnoid hemorrhage -cerebral aneurysm -arteriovenous malformation | hemorrhagic stroke |
| Sx: “exploding headache”, early and sudden changes in LOC, vomiting | hemorrhagic stroke (other symptoms similar to that of ischemic stroke) |
| disruption of the blood supply caused by an obstruction, usually a thrombus or embolism, that causes infarction of brain tissue | ischemic stroke |
| paralysis of one side of the body, or part of it, due to an injury in the motor area of the brain | hemiplegia |
| weakness of one side of the body, or part of it, due to an injury in the motor area of the brain | hemiparesis |
| defects of articulation due to neurologic causes | dysarthria |
| inability to express oneself or to understand language | aphasia (expressive, receptive) |
| blindness of half of the field of vision in one or both eyes | hemianopsia |
| temporary neurologic deficit resulting from a temporary impairment of blood flow; “warning of an impending stroke”; diagnostic workup is required to treat and prevent irreversible deficits | Transient Ischemic Attack (TIA) |
| TPA given for which type of stroke? | ischemic stroke |
| causes: -high blood pressure -injury -bleeding disorders -cocaine use -abnormal blood vessels -aneurysm | hemorrhagic stroke |
| Tx: care is primarily supportive; bed rest with sedation; oxygen; Tx of vasospasm, increased ICP, hypertension, potential seizures, and prevention of further bleeding ; VS q 15-mins; NPO initially | hemorrhagic stroke |
| a hole in the septum b/w the right and left ventricle that results in increased pulmonary blood flow (left-to-right shunt); loud, harsh murmur heard at left sternal border; many close spontaneously | ventricular septal defect (VSD) |
| VSD: surgical closure may be in the form of suture closure of the VSD, transcatheter placement of a device in the defect, or ____ patch closure | Dacron |
| VSD: with the clamshell occluding or _____ device, strenuous activity should be avoided for 1 month after the procedure | Amplatzer |
| VSD: monitor for what? | ventricular dysrhythmias or AV block |
| S/Sx: hypotension, tachycardia, hypovolemic shock, hemorrhage | DIC |
| Primary risk factor for CVA | hypertension |
| (some) TPA criteria? | -18y.o.+ -ischemic stroke -SBP < 185, DBP <110 -not taking Coumadin -no heparin w/in past 48-hrs |
| TPA time frame? | within 3-hrs (some facilities now up to 12-hr window) |
| What would happen if TPA given for hemorrhagic stroke? | they would bleed out |
| med given for uncontrolled HTN? | nicardipine (Cardene) |
| main diagnostic test for CVA? | CT scan |
| VS how often after administering TPA? | every 5-mins, then 15 |
| S/Sx of VSD? | murmur, cyanosis, edema, crackles, failure to thrive, increased work of breathing, dysrhythmias **remember to think Sx similar to those of heart failure |
| VSD Tx done when? | early in young infancy |
| VSD post-op time frame for period of healing? | 4 weeks |
| ___ is a controversial Tx strategy that treats DIC by interrupting the thrombosis process. | Heparin infusion |
| What triggers may lead to the development of DIC? | -sepsis -trauma -cancer -shock -abruptio placenta -toxins -allergic reactions |
| The primary cerebrovascular disorder in the U.S. is ____, which is also called a _____ to emphasize the urgency of its occurrence. | stroke; brain attack |
| The main surgical procedure for managing TIAs is _____. | carotid endarterectomy |
| _____ is the most common cause of cerebrovascular disease. | Arteriosclerosis |
| The most common motor dysfunction of a stroke is _____. | hemiplegia |
| Hemorrhagic strokes are caused by bleeding into ____, _____, or ______. | brain tissue, the ventricles, the subarachnoid space |
| The most common cause of intracerebral hemorrhage is ____. | hypertension |
| ____ and ____ are the two categories of stroke. | ischemic, hemorrhagic |
| diet used to decrease risk of coronary heart disease and stroke? what foods are in this diet? | Dietary Approaches to Stop Hypertension (DASH); DASH diet is high in fruits and vegetables, moderate in low-fat dairy products, and low in animal protein |
| Nurse recognizes that a pt is exhibiting Sx associated w/TIA. After what period of time does the nurse determine these Sx will subside? -1 hour -3-6 hours -12 hours -24-36 hours | 1 hour |
| A pt that had a stroke is experiencing memory loss and impaired learning capacity. Which lobe does the nurse determine that brain damage has most likely occurred? -frontal -occipital -parietal -temporal | frontal |
| Pt is exhibiting classic signs of hemorrhagic stroke. What report from the pt would be an indicator of this type of stroke? -numbness of an arm or leg -double vision -severe headache -dizziness and tinnitus | severe headache |
| Nurse is caring for a pt having a hemorrhagic stroke. What position in the bed will the nurse maintain this pt? -high Fowler's -prone -supine -semi-Fowler's | semi-Fowler's |
| When should the nurse plan the rehabilitation of a pt who is having an ischemic stroke? -the day before the pt is d/c'd -after the pt has passed the acute phase of the stroke -after the nurse has rec'd the d/c orders -the day the pt has the stroke | the day the pt has the stroke |
| Pt who has had a stroke begins having complications re: spasticity in the lower extremity. What med is given to help alleviate this problem? -diphenhydramine -lioresal -heparin -pregabalin | lioresal |
| Pt having a stroke is having difficulty forming words. What would the nurse document this finding as? -ataxia -arthralgia -dysphasia -dysarthria | dysphasia |
| What are the cognitive deficits the nurse recognizes the pt has as a result of a stroke? (select all) -poor abstract reasoning -decreased attention span -short- and long-term memory loss -expressive aphasia -paresthesias | -poor abstract reasoning -decreased attention span -short- and long-term memory loss |
| What clinical manifestations does the nurse recognize when a pt has had a right hemispheric stroke? -left visual field deficit -aphasia -slow, cautious behavior -altered intellectual ability | left visual field deficit |
| Which is a contraindication for the administration of tissue plasminogen activator (t-PA)? -Intracranial hemorrhage -Ischemic stroke -Age 18 years or older -Systolic blood pressure less than or equal to 185 mm Hg | Intracranial hemorrhage (Intracranial hemorrhage, neoplasm, and aneurysm are contraindications for t-PA. Clinical diagnosis of ischemic stroke, age 18 years or older, and a systolic blood pressure less than or equal to 185 mm Hg are eligibility criteria.) |
| The nurse is participating in a health fair for stroke prevention. Which will the nurse say is a modifiable risk factor for ischemic stroke? -Thyroid disease -Social drinking -Advanced age -Smoking | Smoking (Modifiable risk factors for transient ischemic attack (TIA) and ischemic stroke include hypertension, type 1 diabetes, cardiac disease, smoking, and chronic alcoholism. Advanced age, gender, and race are nonmodifiable risk factors for stroke.) |
| Which term refers to the inability to perform previously learned purposeful motor acts on a voluntary basis? -Agnosia -Agraphia -Perseveration -Apraxia | Apraxia (Verbal apraxia refers to difficulty forming and organizing intelligible words although the musculature is intact. Agnosia--failure to recognize familiar objects perceived by the senses. Agraphia--disturbances in writing intelligible words.) |
Created by:
nurse savage
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