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Stroke Review

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Answer
What is TIA?   A neurological event with the signs and symptoms of a stroke but which go away within a short period of time. It is due to a temporary lack of adequate blood and oxygen (ischemia) to the brain.  
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Define Stroke?   A disruption in the cerebral blood flow  
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What causes a stroke?   Can be caused by ischemia, hemorrhage or embolism  
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What the most common s/s of stoke?   sudden numbness or weakness of face, arm or leg, sudden confusion, trouble speaking or understanding, sudden trouble seeing in one or both eyes, sudden trouble walking dizziness, loss of balance or coordination, sudden severe headache with no known cause.  
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what does the nurse do IMMEDIATELY when she/he sees the s/s of stroke?   ensure airway. Remember ABC's = Pass nclex  
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What tips can you give the CNA help feeding a new patient post CVA   -know patient's swallow, gag and -coughing abilities -thicken liquids to avoid aspiration - food placed in back of mouth on the unaffected side -suction on stand by distraction free eating environment  
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What tips can you give a CNA who is going to explain the morning routine to a new patient who has just had a CVA?   - Talk more slowly -Look Directly at pt face -Allow plenty of time for the pt to answer -Give instructions one step at a time  
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What is the time frame for a patient having a stroke to be eligible for thrombolytic drug?   To be eligible to receive thrombolytic therapy for a stroke, patients myst learn to recognize symptoms and seek help at an emergency department within 3 hours of symptom onset.  
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aphasia   difficulty with language use or comprehension  
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alexia=agraphia   difficulty reading  
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apraxia   inability to carry out a learned task such as pick up food with a fork or make words  
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ataxia   uncoordinated movement  
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dysarthria   difficulty speaking  
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dysphagia   difficulty swallowing  
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hemiplegia   one sided paralysis  
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hemianopsia   one sided weakness  
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homonymous hemianopsia   loss of vision on one side  
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describe s/s of LEFT cerebral infarction   aphasia alexia agraphia ataxia apraxia right hemiplegia or hemiparesis slow, cautious behavior depression and quick frustration visual changes such as hemianopsia  
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describe s/s of RIGHT cerebral infarction   unawareness of dficit (neglect syndrome, overestimation of inabilities) Loss of depth perception Disorientation Impulse control difficulty poor judgment left hemiplegia or hemiparesis Visual changes such as hemianopsia  
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a left-handed person is --- hemisphere dominate   right  
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a right handed person is ---- hemisphere dominant?   left  
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What is the priority function of cerebral frontal lobe?   Motor  
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What is the priority function of cerebral parietal lobe?   sensory  
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What is the priority fcn of the cerebral occipital lobe?   vision  
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what part of the brain coordinates: speech, auditory center, LT memory   Temporal Lobe  
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What part of the brain coordinates: smooth muscle movements, posture, equilibrium, muscle tone, position sense (proprioception)   Cerebellum  
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What happen to the vision of a patient with hemianopsia?   Damage to the right side of the posterior portion of the brain may cause a loss of the left field of view in both eyes. Damage to the left posterior brain may cause a loss of the right field of vision.  
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Stroke is?   A disruption in the cerebral blood flow  
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Stroke can be caused by?   ischemia, hemorrhage, Embolism HIE - Hemorrhage, Ischemia and Embolism  
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What are risk factors for Stroke?   HTN atherosclerosis, hyperlipidemia, DM, cocaine use, atrial fibrillation, smoking, use of oral contraceptives, obesity, hypercoagulabilty, cerebral aneurysm  
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What does the nurse do immediately when she sees s/s?   Assure patency of airway, assess LOC, elevate the head, take seizure precautions, maintain quiet environment assist patient to make needs known, respond to swallowing deficits, e.g. thickened liquids  
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A nurse is delegating transfer of a pt w/ a left hemispheric stroke from the bed to a w/c. Which side of the pt should the w/c be placed?   Left  
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A nurse is pl;anning care for the client with hemiparesis of the right arm and leg. Then nurse incorporates in the care plan placement of objects.   within the patients reach on the let side  
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A pt w/ stroke has residual dysphagia. When a diet order is initated, the nurse avoids doing which of the following?   Giving the patient thin liquids  
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A nurse is trying to communicate with a patient who has had a stroke. The patient has aphasia which action by the nurse would be the least helpful to the pt?   Speaking to the patient at a slower rate Completing sentences that the patient cannot finish.  
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a nurse is speaking to a high school class about good health practices. A student raises his hand and says that he has heard that "doing meth can make you a vegetable." What is the best reply for the nurse to give?   A methamphetamines can cause vasocontriction and brain ischemia increasing the risk of stroke to 5 fold.  
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