Neuro Exam- Stroke
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| Disruption of the cerebral blood flow d/t an obstruction. | Ischemic Stroke aka Brain Attack or Cerebrovascular Accident (CVA)
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| Complex series of metabolic events which occurs in stroke | Ischemic Cascade
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| 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
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| The _______ region is centered around the infarction can be salvaged with timely intervention at each step. | Penumbra
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| Ischemic brain ages _____ years each hour without treatment | 3.6
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| Ischemia from diminished 02 results in | necrosis of brain tissue
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| Early treatment with _________ provides better outcomes, which is why knowing ________ is SO VITAL! | thrombolytics, when CVA began
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| Most common motor dysfunction with CVA | Hemiplegia
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| Paralysis of one side of the body | Hemiplegia
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| Weakness of one side of the body | Hemiparesis
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| Difficulty walking, unsteady gait, loss of balance or coordination | Ataxia
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| DTRs usually reappear after ___ hours along with spasticity, increased tone, on the affected side | 48
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| Difficulty in speaking from paralysis of speech muscles | Dysarthia
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| Impaired speech | Dysphasia
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| Loss of speech | Aphasia
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| Broca's area affected. Inability to express oneself. | Expressive aphasia
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| Wernicke's are affected. Inability to understand language. | Receptive aphasia
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| Mixed type of aphasia | Global aphasia
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| Inability to perform a previously learned action. Seen when pt makes verbal substitutions for words. | Apraxia
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| The ability to interpret sensation | Perception
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| Visual-perception dysfunctions are problems between the eye and ________ | Visual cortex
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| Loss of half the visual field | Homonymous Hemianopsia
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| Problems with perceiving the relationship of 2 or more objects in spacial area are frequently seen in pts with _________hemispheric damage. | right
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| Sensory loss. Problem interpreting by sight, touch, or hearing. | Agnosia
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| If damage to the _________ lobe, learning capacity, memory, or other higher cortical intellectual functions impaired. | Frontal
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| Abrupt change in emotional behavior from crying to laughing. | Emotional incontinence
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| #1 Diagnostic test for CVA is _______ to R/O ______ | Non-contrast CT, Ischemic or hemorrhage stroke
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| What two tests, other than CT, used for Dx CVA | EKG (source of thrombus) and Carotid US
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| Temporary neuro s/s lasting less than 1 hour | TIA
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| Warning sign of stroke | TIA
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| Sudden loss of motor, sensory, and/or visual function | TIA
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| Primary major, modifiable risk factor for stroke | HTN
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| Three non-modifiable risk factors for stroke | Age (>55), Gender (M), and Race (AA)
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| Used ONLY for ischemic strokes | Thrombolytics
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| t-PA must be given within _______ of s/s onset | 3 hours
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| What is the max dose of t-PA? | 90 mg
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| t-PA is given ____mg/kg | 0.9
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| #1 SE t-PA | Bleeding
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| 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
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| 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
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| t-PA eligibility requirements state person must have a BP less than | 185/110
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| Three assessment priorities | Airway, Cardiac, Neuro
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| Name three non-thrombolytic therapies | Anticoagulants, Anitplatelet, symptomactic treatment
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| Two Anticoagulant therapies and their labs | IV Heparin (aPTT) and IV Coumadin (INR, PT)
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| Position HOB at _____ and have _____ available to manage secretions. | 25-30, suction
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| ______ muscles are stronger than extensor | Flexor
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| Prevent shoulder ________ with correct positioning. | Adduction
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| Distal joints should be ________ than proximal. | Higher
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| What labs should we look at for nutrition? | Albumin and protein
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Created by:
mreedy
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