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NSG 210 Ch. 62

Mgmt of Pt w/ Cerebrovascular Disorders

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