General Q's of SCRN
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
|
|
||||
|---|---|---|---|---|---|
| show | Medial portion of the frontal and parietal lobes ("mohawk"); corpus callosum
🗑
|
||||
| What areas does the MCA feed? (i.e. lobes and/or structures) | show 🗑
|
||||
| What areas does the PCA feed?(i.e. lobes and/or structures) | show 🗑
|
||||
| What are the major S/S of MCA stroke? | show 🗑
|
||||
| show | Contralateral motor deficits (some/few sensory), Foot & leg weaker than arm, face and tongue usually spared, abulia (decreased activity and speech), emotionally labile
🗑
|
||||
| What are the major S/S of PCA stroke? | show 🗑
|
||||
| show | Hemiparesthesia, followed by isolated hemisensory deficit in face, arm, & leg, may include trunk, pain may develop resistant to treatment; can also have abnormal movements (inability to stand or walk--thalamic astasia); hyper-reflexive tendons, babinski
🗑
|
||||
| What are the major S/S of basal ganglia strokes? | show 🗑
|
||||
| show | Only if history of CAD, especially if they have stents
🗑
|
||||
| show | 2.5
🗑
|
||||
| What is the target LDL after stroke? (Which would indicate initiation of statin therapy) | show 🗑
|
||||
| What is the target blood pressure AFTER stroke or TIA (secondary prevention)? | show 🗑
|
||||
| show | Cranial nerves 9-12
🗑
|
||||
| show | Cranial nerves 3-4
🗑
|
||||
| What crania nerves originate from the pons? | show 🗑
|
||||
| What are the S/S of carotid dissection? | show 🗑
|
||||
| show | Nerve tract for the motor cortex
🗑
|
||||
| show | Nearly ALL sensory pathways coming from the cerebral cortex
🗑
|
||||
| show | Hyper-somnolence
🗑
|
||||
| show | BODY TEMPERATURE ;
also (but less prolific), affect circadian rhythm and body H20/osmo
🗑
|
||||
| What is Broca's aphasia? | show 🗑
|
||||
| Where is Broca's area located? | show 🗑
|
||||
| What is Werneckies aphasia? | show 🗑
|
||||
| show | At the temporo-parietal junction
🗑
|
||||
| show | Midbrain
🗑
|
||||
| When is treatment for carotid stenosis considered? | show 🗑
|
||||
| show | At the Foramen of Monro (a 'channel' that lies between the lateral ventricles and the third ventricle)
🗑
|
||||
| show | Disorder in which protein deposits in brain damage vessels, causing micro hemorrhages--and important risk factor for ICH!!
🗑
|
||||
| show | Statins
🗑
|
||||
| show | NECT (Non-contrast CT)
🗑
|
||||
| show | Before: NPO 4-6hrs, PT/INR, allergies to shellfish/iodine, consent
After: Bedrest 6hrs, HOB only to 30 degrees, assess for bleeding/circulation, avoid flexing & hyper flexing affected extremity for 12-24hrs, liberal fluid intake
🗑
|
||||
| show | Cerebral Angiography
🗑
|
||||
| show | More sensitive than NECT for ischemic strokes
🗑
|
||||
| What is digital subtraction angiography (DSA) used for? Particularly, what is it "best" at detecting? | show 🗑
|
||||
| What is TCD used for? | show 🗑
|
||||
| show | biopsy
🗑
|
||||
| What would be the characteristics of CSF after an LP that would indicate SAH? | show 🗑
|
||||
| show | PFO (patent foramen ovale)
🗑
|
||||
| What is the target SpO2 in stroke patients? | show 🗑
|
||||
| What is desired EMS arrival time to possible stroke patient? | show 🗑
|
||||
| What are the three structures of the brain stem (in order)? | show 🗑
|
||||
| What are the structures of the basal ganglia? | show 🗑
|
||||
| What are the structures of the diencephalon? | show 🗑
|
||||
| What are the structures of the limbic system? | show 🗑
|
||||
| Are strokes more prevalent in men or women? | show 🗑
|
||||
| Does family history of stroke affect one's risk? | show 🗑
|
||||
| What is the #1 modifiable risk factor for preventing both ischemic and hemorrhagic stroke? | show 🗑
|
||||
| show | Doubles risk
🗑
|
||||
| Having D.M increases stroke risk by how much? | show 🗑
|
||||
| show | Less than 7
🗑
|
||||
| show | 4-5x times risk; strokes usually larger
🗑
|
||||
| What are ICH risk factors? | show 🗑
|
||||
| show | Yes, but very weak, in comparison to ischemic
🗑
|
||||
| show | Smoking (#1), ETOH, HTN, family history, sex (women, men only after 50 more prevalent), race (blacks)
🗑
|
||||
| Approximately how many neurons are lost every minute in large strokes? | show 🗑
|
||||
| What is the most important 'patient history' information for EMC crews to attain from a suspected stroke patient? | show 🗑
|
||||
| What is the goal time for stroke patient to see MD? | show 🗑
|
||||
| What is the goal time for stroke patient to see stroke team? | show 🗑
|
||||
| show | 25min
🗑
|
||||
| show | 45min
🗑
|
||||
| What is the goal time for patient to get TpA? | show 🗑
|
||||
| What will appear white (hyperdense) in a CT scan? | show 🗑
|
||||
| What will appear dark gray (hypodense) in CT scan? | show 🗑
|
||||
| What will appear black in CT scan? | show 🗑
|
||||
| show | Approximately 6-8hrs
🗑
|
||||
| show | CT scan
🗑
|
||||
| show | Immediately
🗑
|
||||
| show | 24-72hrs
🗑
|
||||
| show | Admit through discharge
🗑
|
||||
| What is one of the drawbacks of the NIH? | show 🗑
|
||||
| If a patient has a NIH score of 14 or more, where can you anticipate he or she will be discharged to? | show 🗑
|
||||
| If a patient has a NIH of 6-13, where can you anticipate he or she will be discharged to? | show 🗑
|
||||
| show | Home
🗑
|
||||
| show | 25%
🗑
|
||||
| show | It is of DEBATE, yet current consensus is a GOAL of 140-180mg/dL
🗑
|
||||
| What is the ideal blood glucose for an ICH stroke patient? | show 🗑
|
||||
| What is the ideal blood glucose for a SAH stroke patient? | show 🗑
|
||||
| What is one of the leading causes of epilepsy in the older population? | show 🗑
|
||||
| show | ONLY for SAH and for a short term (3-7days)
🗑
|
||||
| show | temporal lobe or cerebral cortex
🗑
|
||||
| show | 25%
🗑
|
||||
| show | 50% in ICU and stroke unit, and up to 11% in post-acute rehab
🗑
|
||||
| What is the rate of urinary incontinence in stoke patients? | show 🗑
|
||||
| When can heparin safely be started as DVT prophylaxis of ICH and SAH patient? | show 🗑
|
||||
| show | Controversial, currently no 'ideal'
🗑
|
||||
| When can warfarin be safely restarted in a stroke patient? | show 🗑
|
||||
| What are the major functions of the parietal lobe? | show 🗑
|
||||
| What are the major functions of the occipital lobe? | show 🗑
|
||||
| What are the major functions of the temporal lobe? | show 🗑
|
||||
| Strokes in what area can leave deficits on both 'sides' of the body? | show 🗑
|
||||
| What are the major signs/symptoms of a lateral medulla (medullary) stroke? | show 🗑
|
||||
| What are the major signs/symptoms of a medial medulla (medullary) stroke? | show 🗑
|
||||
| What are the major signs/symptoms of a cerebellar stroke? | show 🗑
|
||||
| show | Hemiparesis, cerebellar symptoms; Lacunar syndromes --> pure motor hemiparesis, transient dizziness, diplopia, nystagmus, dysarthria, dysphagia, ataxic hemiparesis
🗑
|
||||
| show | Behavior/emotions, contains motor cortex in posterior aspect; Broca's area (expressive aphasia)
🗑
|
||||
| What are major signs/symptoms of midbrain strokes? | show 🗑
|
||||
| What is the only FDA approved Rx for acute stroke? | show 🗑
|
||||
| show | 0.9mg/kg to a max dose of 90mg
🗑
|
||||
| At what rate is tPA administered? | show 🗑
|
||||
| show | Stop TPA, notify MD, anticipate STAT CT--there are no standardized measures to treat patient if they have indeed bled post TPA--cryoprecipitate and/or platelets can be considered
🗑
|
||||
| What are the major S/S of a medial thalamic stroke? | show 🗑
|
||||
| What can carotid bruit indicate? | show 🗑
|
||||
| show | Osler nodes and Janeway lesions are nodes/ulcerations on hands and feet (osler nodes are painful) that indicate INFECTIVE ENDOCARDITIS--a big risk factor for stroke
🗑
|
||||
| show | STEROIDS mainline, can consider immunosuppressants
🗑
|
||||
| What is normal CPP (Cerebral Perfusion Pressure)? | show 🗑
|
||||
| What is the treatment for cocaine induced hypertension? | show 🗑
|
||||
| show | On the affected side
🗑
|
||||
| show | 5-15mmHg (greater than 20 is considered 'increased')
🗑
|
||||
| show | MANNITOL to reduce cerebral edema (can also consider hypertonic saline, ventricular drains, decompresive surgery, mild hypocarbbia [hyperventilation to reduce CO2, which vasodilates])
🗑
|
||||
| show | 30-35mmHg
🗑
|
||||
| show | NO, not recommended
🗑
|
||||
| show | 5-7 days, which is the same as the life of platelets themselves (therefore, considered irreversible)
🗑
|
||||
| show | 5-7 days, which is the same as the life of platelets themselves (therefore, considered irreversible)
🗑
|
||||
| Are Brilanta and Effient ideal for secondary stroke prevention? | show 🗑
|
||||
| What is the half-life of Warfarin? What is the onset? | show 🗑
|
||||
| Are novel anticoagulants (Pradaxa, Eliquids, Xarelto) indicated for A-FIB CAUSED by a HEART VALVE ISSUE? | show 🗑
|
||||
| Orolingual angiodema is a potential side effect of what drug? | show 🗑
|
||||
| What should BP be BEFORE starting tPA? What about DURING & AFTER tPA? | show 🗑
|
||||
| How often should vitals be checked during tPA infusion? | show 🗑
|
||||
| How long does TPA remain in body? | show 🗑
|
||||
| show | -Over 80yrs old
-Pt. on anticoagulant therapy (regardless of INR)
-NIH greater than 25
-Patients with history of stroke AND diabetes
🗑
|
||||
| show | #1 BASAL GANGLIA, #2 is thalamus
🗑
|
||||
| A stroke in what area can cause ipsilateral 'drunk-like' motor dysfunction? | show 🗑
|
||||
| show | Locked-in syndrome
🗑
|
||||
| show | Atrial fibrillation
🗑
|
||||
| What is the 'threshold' GCS score that would indicate a need for intubation? | show 🗑
|
||||
| show | Only treat if higher than 220/120; after 24hr period, we can begin to decrease BP by 10-15%
🗑
|
||||
| show | Re-establish blood flow and save the penumbra
🗑
|
||||
| When and for how long should nimodopine be started on a SAH patient? | show 🗑
|
||||
| show | 60mg q4h for 21 days (may do 30mg q2h if patient becomes hypotensive)
🗑
|
||||
| show | DECREASES INCIDENCE/prevents vasospasm, DOES NOT TREAT IT
🗑
|
||||
| show | Lets us know if a stroke was cardioembolic (from heart) or thrombotic (from cranial arteries)
🗑
|
||||
| show | MRI/MRA with gradient echo
🗑
|
||||
| When should LP be considered for SAH diagnosis? | show 🗑
|
||||
| show | Retraining the 'good' arm of the patient to "force them" to use the affected (weaker) side.
ONLY USE WITH ARMS--IF USED IN LOWER EXT, CAN CAUSE FALLS!
🗑
|
||||
| show | Tolerate 3hrs of therapy 5 days a week, need two or more disciplines (OT/ST/PT), be medically stable
🗑
|
||||
| When is the peak incidence of vasospasm after SAH? | show 🗑
|
||||
| show | A chronic, vaso-occlusive disease that leads to narrowing and eventual occlusion of the internal carotids and branching vessels. It is very prominent in YOUNG ASIAN WOMEN.
🗑
|
||||
| How is Moyamoya disease treated? | show 🗑
|
||||
| show | CVT is a rare type of stroke in which a clot forms in the dural sinuses or the cerebral veins.
It is treated with acute anticoagulation, start with hep. drip, then oral for a few months; closely monitored
🗑
|
||||
| What is the standard treatment for arterial dissections? | show 🗑
|
||||
| What is the standard treatment for AVM's? | show 🗑
|
||||
| How many stroke core measures are there? | show 🗑
|
||||
| show | lack of CSF absorption
🗑
|
||||
| What causes obstructive (non-communicating) hydrocephalus? | show 🗑
|
||||
| What is the penumbra? | show 🗑
|
||||
| show | NECROTIC pathway (cells die due to lack of O2 and sugar) and APOPTOTIC pathway (cells die due to 'programmed' death since the one's around them are dying)
🗑
|
||||
| show | Release of thrombin at site, vasogenic edema, blood-brain barrier disruption, inflammatory response
🗑
|
||||
| show | Saccular (also known as berry aneurysms) [which are the most common], and fusiform
🗑
|
||||
| show | Transient blindness in one eye; common with internal carotid (ICA) strokes [because the ophthalmic artery branches from the ICA]
🗑
|
||||
| What is Marcus Gunn pupil and what can cause it? | show 🗑
|
||||
| What are watershed strokes? What generally causes them? | show 🗑
|
||||
| show | Defined as ipsilateral cerebral blood flow above brain tissue needs; can occur after revascularization (carotid stent or endarterectomy, TPA)
🗑
|
||||
| What are s/s of reperfusion syndrome? | show 🗑
|
||||
| What is the treatment for reperfusion syndrome? | show 🗑
|
||||
| show | aSAH
🗑
|
||||
| show | INR 1.7 or less (PT of 15 or less)
🗑
|
||||
| Angioedema is a common side effect of what medication? | show 🗑
|
||||
| What is the treatment of choice for patients with SYMPTOMATIC carotid stenosis and greater than 70% occlusion? | show 🗑
|
||||
| In patients with a patent foramen ovale (PFO), what is the ideal treatment? | show 🗑
|
||||
| show | Exercise and ROM stretching
🗑
|
||||
| show | Teaching a patient to be self-sufficient, decrease dependence on others, and achieve the highest functional level realistically possible
🗑
|
||||
| What is a common side effect of Coumadin (aside from bleeding)? | show 🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Created by:
DZLJAD
Popular Nursing sets