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Stroke
| Question | Answer |
|---|---|
| non-modifiable risk factors of stroke | age, gender, ethnicity/race, family history / genetics |
| modifiable risk factors of stroke | hypertension, obesity, smoking, heart disease, serum cholesterol, metabolic syndrome, inactivity, poor diet, drug / alcohol abuse, sleep apnea |
| transient ischemic attack | transient episode of neurologic dysfunction caused by focal brain, spinal cord or retinal ischemia but without acute infarction of the brain --> MEDICAL EMERGENCY |
| thrombotic stroke | process of clot formation results in narrowing of the lumen, which blocks passage of blood through the artery |
| embolic stroke | when emboli reach an artery in the brain that is too narrow to pass through, it lodges and blocks the flow of blood |
| hemorrhagic stroke | burst in a blood vessel may allow blood to seep into and damage brain tissue until clotting shuts off the leak |
| ischemic stroke | results from inadequate blood flow to the brain from partial or complete occlusion of artery |
| ischemic strokes can be | thrombotic or embolic |
| thrombotic ischemic strokes | occur when injury to vessel wall occurs, due to diabetes or HTN, and patient is unconscious |
| embolic ischemic stroke | due to infarction, sudden onset and patient remains conscious |
| hemorrhagic stroke | results from bleeding into brain tissue itself |
| in subarachnoid space a hemorrhagic stroke is caused by | trauma, drug abuse, or rupture of an aneurysm |
| clinical manifestations of a hemorrhagic stroke | decreased LOC, headache, N/V, HTN |
| clinical manifestations of stroke | impairment of movement, loss of gag reflex, aphasia, dysarthria, difficulty controlling emotions, memory and judgement issues, spatial-perception alteration, and elimination issues |
| non-contrast CT scan | differentiates between ischemic and hemorrhagic stroke |
| MRI | indicates size/location of lesion useful with ischemic events |
| BE FAST | Balance, Eyes, Face, Arms, Speech, Time |
| Assessment of stroke | airway --> supplemental oxygen needed breathing circulation --> increased BP |
| preventative care for TIA | antiplatelet drugs - ASA, ticlidopine (Ticlid), Clopidogrel (Plavix) |
| preventative care for elevated cholesterol | statins (only if nutrition and exercise are ineffective) |
| Ischemic stroke treatment | BP management - gradually reduce the BP (labetalol) then thrombolytics --> tPA |
| side effects of tPA | increased risk of bleeding |
| tPA is only effective if | given within 3-4.5 hours of onset of first symptom |
| TIA treatment | resolves within 24 hrs some may have early symptoms that will progress to stroke may need carotid endarectomy or stenting |
| intracerebral hemorrhagic stroke treatment | control blood pressure |
| SAH aneurysm rupture treatment | surgical --> craniotomy or stent or coil of aneurysm |
| SAH management | BP control, prevent vasospasm (Nimodipine), prevent hypovolemia, |
| what should blood pressure be between to manage SAH | 150-160 systolic |
| what meds help keep the BP 150-160 | dopamine, phenylephrine |
Created by:
ebrewer12
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