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Neuro Exam- Stroke

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