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NSG 210 Ch. 62
Mgmt of Pt w/ Cerebrovascular Disorders
| Question | Answer |
|---|---|
| What is 3rd leading cause of death in US? | stroke |
| What are two types of strokes | ischemic(CVA) and hemorrhagic |
| A CVA or "brain attack" is a sudden loss of ______ resulting from what? | function, blood supply to a part of the brain |
| numbness of arm/face/leg on one side of body, confusion, speech probs, visual probs, loss of balance, sudden sever HA are s/s of which stroke | ischemic/CVA |
| A pt presents with hemiplegia on her left side r/t stroke. What does this mean? | Paralysis on left side r/t stroke/lesion affecting right side of brain |
| Often the deep tendon reflexes are seen to be decr and weakness on one side of body is present, what is the term for this? | hemiparesis |
| dysarthria, aphasia, apraxia are common in stroke pt, and affect what brain fx? Define each. | communication dysarthria: diff. in speaking aphasia: loss of speech dysphasia: impaired speech apraxia: inability to perform a previously learned action |
| homonymous hemianopsia refers to | loss of 1/2 of visual field and is seen in perceptual disturbances in stroke pt |
| The inability to recognize previously familiar objects perceived by 1 or more of senses is defined as | agnosias |
| Pt shows altered intellectual ability, slow, cautious behavior, aphasia(expressive/receptive/global, R visual field deficit, R side body paralysis/weakness mean stroke where? | L hemispheric stroke |
| R hemishperic stroke presents with what s/s? | paralysis/weakness on L side, L visual field deficit, spatial/perceptual deficit, incr distractability, impulsive beh, poor judgement, lack of awareness |
| What is the key risk factor to preventing a stroke | HTN, controlling it |
| Other risk factors to control to prevent stroke | A-fib, hyperlipidemia, DM, smoking, asymptomatic carotid stenosis, obesity, too much alcohol/cocaine |
| What defines a TIA? That defines a RIND? | TIA: neurologic deficit lasting <1h up to 24h RIND: last 24-48h |
| What is the least cost effective medical mgmt for stroke prevention and mgmt? | aspirin |
| What are other medical mgmt drugs for stroke? | Coumadin, Plavix, Heparin |
| What is used to dissolve clots that block blood flow to the brain | thrombolytic drugs like t-PA |
| The time of the onset of the stroke has to be ______ as a criteria for t-PA therapy. | 3h or less |
| Other criteria for using t-PA | not taking Warfarin, PTT 15 or less, INR 1.7 or less, no stroke/head inj/intracranial surger w/in 3mos, no gastro/urinary bleeding in 21 days |
| What is leading SE of t-PA | bleeding |
| What is an endarterectomy | main surgical procedure for pt w/ TIAs and mild strokes. It removes plaque/thrombus from carotid art |
| Improving mobility and preventing contractures is nsg intv, how is that accomplished? | prevent adduction of arms by putting pillow under axilla. Lateral side lying and prone position promote hyperextenion of hip to help in gait training. ROM important |
| Where are hemorrhagic strokes found? | intracranial or subarachnoid hemorrhage(aneurysm-weak art wall), essentially bleeding into brain tissue/ventricles mainly due to HTN |
| A pt with a ruptured aneurysm usually shows what s/s | severe HA, LOC, rigidity of neck, visual loss, diplopia, ptosis |
| What is drug therapy for HTN to prevent stroke? | urgency: apresoline emergency: Nipride |
Created by:
palmerag
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