Cerebrovascular Disorders (Neuro 3)

The majority of strokes in the US are __________

ischemic (87%)

What are the nonmodifiable risk factors for stroke?

• >55 yrs old

• female

• black

What is the acronym for clinical manifestations of stroke?

BEFAST

The following are s/s of ___________-side brain damage:

• spacial-perceptual deficits

• poor judgement

• impulsivity

• neglect of the left side

right-side

The following are s/s of ___________-side brain damage:

• impaired language

• slow performance

• cautious behavior

• right-sided weakness

left-side

What are some of the spatial-perceptual deficits in right-sided stroke?

• ___________ — incorrect perception of self and illness

• ___________ — ignoring stimuli from the left visual field

• ___________ — loss of vision in the same half of both visual fields

• ___________ — inability to recognize familair objects or people

• ___________ — inability to perform previously learned skilled movements

• anosognosia — incorrect perception of self and illness

• unilateral neglect of affected side — ignoring stimuli from the left visual field

• homonymous hemianopsia — loss of vision in the same half of both visual fields

• agnosia — inability to recognize familair objects or people

• apraxia — inability to perform previously learned skilled movements

Idenfity the morot deficits of stroke:

• _______________ — loss of skilled voluntary movement

• _______________ — problems with muscular control of speech

• _______________ — weakness

• _______________ — paralysis

• akinesia — loss of skilled voluntary movement

• dysarthria — problems with muscular control of speech

• hemiparesis — weakness

• hemiplegia — paralysis

_____________ — Caused by occlusion of a cerebral artery by thrombus or embolus, resulting in tissue infarction. Treatment focuses on restoring blood flow and preventing further clot formation.

ischemic stroke

_____________ — Results from bleeding into brain tissue or surrounding spaces, causing pressure, irritation, and oxygen deprivation. Treatment focuses on controlling bleeding and reducing intracranial pressure.

hemorrhagic stroke

What is the first image/test done to diagnose stroke?

non-contrast CT scan

__________ is the gold standard for acute ischemic stroke if given within 3-4.5 hours

tissue plasminogen activatory (tPA)

What drug classes are secondary prevention for ischemic strokes?

• anticoagulants: Warfarin, dabigatran, apixaban, edoxaban, rivaroxaban

• antiplatelets: Aspirin, clopidogrel

• statins: Atorvastatin, simvastatin

• antihypertensives: ACE inhibitors, diuretics

____________ is the most serious complication of tPA therapy and can be detected via BP

hemorrhagic transformation

What position should the head of the bed be in for a patient suffering from a stroke?

atleast 30 degrees to improve venous drainage and manage ICP

T/F: a RN should allow higher-than-normal BP in acute ischemic stroke PTs to maintain cerebral perfusion to the penumbra (potentially salvageable tissue surrounding the infarct core)

True

__________________ are brief episodes of neurological dysfunction (suddent onset of focal neurological deficits) without infarction, in whuch symptoms resolve within 24 hours but are a warning sign of a future stroke (within 48 hours)

transient ischemic attacks (TIA)

___________ hemorrhage — bleeding directly into brain parenchyma and often due to uncontrolled hypertension

intracerebral hemorrhage

_____________ hemorrhage — bleeding into subarachnoid space and most commonly due to ruptured aneurysm

subarachnoid hemorrhage

The following are s/s of which type of hemorrhagic stroke:

• sudden, severe headache (“worst headache of life”)

• nausea and vomiting

• early and rapid change in LOC

• focal neurological deficits similar to ischemic stroke

• seizures

• elevated BP

• progression of symptoms over minutes to hours

intracerebral hemorrhage

The following are s/s of which type of hemorrhagic stroke:

• thunderclap headcahe (sudden, excruciating)

• nuchal rigidity (stiff neck)

• photophobia

• loss of consciousness in severe cases

• visual distrubances

• tinnitus

• dizziness

• hemiparesis may be present

subarachnoid hemorrhage

What meds can be adminsitered for hemorrhagic stroke?

• anticoagulation antidotes

• antihypertensives

• anticonsulsants

T/F: anticoagulants and antiplatelets should be administered in the acute phase of hemorrhagic stroke

false; anticoagulants and antiplatelets are contraindicated in acute hemorrhagic stroke