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62 Cards in this Set
- Front
- Back
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A ____ is the result of decreased blood flow to a localized area of the brain.
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CVA
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A CVA is also called a ____.
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brain attack
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Risk factors for CVA include:
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-elevated blood cholesterol
-family history -uncontrolled HTN -diabetes -atrial fibrillation -sleep apnea -low birth weight -age -smoking -substance abuse -sickle cell anemia -obesity -living in the stroke belt |
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One of the biggest risk factors for CVAs is _____.
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uncontrolled hypertension
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____ are an early precursor to a stroke.
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TIAs
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The onset of a TIA is ____ but S/Sx disappear _____.
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sudden
within minutes |
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A Transient Ischemic Attack is a brief period of ischemia that causes _____.
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neurodeficits
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Manifestations of a TIA are the
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-sudden onset of neurological deficits with quick resolution
(vision, speech, movement, limited mobility, tingling arm, etc...) |
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Treatment after a TIA includes controlling ____, ____ diet, ____ cessation, _____ agents and teach patient about S/Sx of CVA and to seek emergency transport.
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Treatment after a TIA includes controlling BP, low fat diet, smoking cessation, antiplatelet agents and teach patient about S/Sx of CVA and to seek emergency transport.
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Antiplatelets are used to control the clotting process. Two of these that are used with TIAs are
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Plavix and Aspirin
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The most common thing for a TIA is a clot that comes off the ____ therefore they should be evaluated first.
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carotids
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Procedures for Tx after a TIA are
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-carotid endoarterectomy
-carotid angioplasty with or without stent |
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A ____ is when the artery in the neck is opened up and the clot is taken out.
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carotid endoarterectomy
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A ____ is when they go in thru the groin, run a catheter up and clear the area.
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carotid angioplasty
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Nursing care for a Post Op Carotid surgery client includes:
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-position client on unoperated side
-HOB at 30 degrees or flat -good alignment of head and neck -avoid rotating, flexing, hyperextension -support the head with movements -assess for complications such as bleeding or Full CVA |
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The most common complication following carotid surgery is ____.
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Full CVA
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A ____ CVA occurs when a large cerebral vessel is occluded by a thrombus that is attached to the artery wall.
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Thrombotic
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With a thrombotic CVA the clot ____ (does/doesn't) move.
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doesn't
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Thrombotic CVAs are common in ____ and ____.
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internal carotids and basilar arteries
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The population at greatest risk for a thrombotic CVA is
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older people who are sleeping because their BP is lower when asleep and there is less pressure to push blood thru an already narrowed lumen.
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A thrombotic cva may present itself as
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numbness of an extremity during the night then paralysis in the morning. It starts minimally and expands. Occurs rapidly and progresses slowly.
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An ____ CVA happens when a piece of a clot breaks off and moves then causes an occlusion as it moves thru smaller and smaller vessels.
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Embolic
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Embolic CVAs are common in people with
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fat emboli and atrial fibrillation. also bacterial endocarditis
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An embolic cva occurs in abt 40% of the population. Often the
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younger, active awake population.
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The clot of an embolic CVA causes ____.
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sudden signs and symptoms
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The locations from which an embolism can travel to the brain are
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L heart
aorta carotid, basilar and vertebral arteries and their branches |
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The most deadly of all strokes is the _____.
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Hemorrhagic CVA
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Increased BP creates considerable stress on a blood vessel. If there is a blood vessel that is weakened there may be a rupture of that blood vessel causing a _____.
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hemorrhagic CVA
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Hemorrhagic CVAs are often seen in people that are ____ with poorly controlled ____. It may also be seen with ruptured aneurysm or a subdural hematoma.
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older adults
hypertension |
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Presentation of a hemorrhagic CVA includes:
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-h/a
-meningeal irritation -NV -flaccid hemaplegia -IICP -death |
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About ___% of CVAs are hemorrhagic.
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20
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Manifestations of a CVA include:
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-motor deficitis
-language deficits -dysphagia -cognitive/behavioral changes -sensory-perceptual deficits -elimination problems -abnormal fields of vision |
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Motor deficits that accompany CVAs are:
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-hemiplegia
-hemiparesis -flaccidity -spasticity -rigidity -contralateral |
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___ is paralysis on half of the body. Pt can't move the arm and leg on that side.
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Hemiplegia
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____ is weakness on half of the body.
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Hemiparesis
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____ is no muscle strength or tome.
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Flaccidity
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____ is spasms causing increased muscle tone.
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Spasticity
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___ is constant reisstance to motion.
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Rigidity
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_____ means that a R sided stroke will have L sided symptoms.
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Contralateral
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FAST is a quick assessment for CVA it stands for
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F= Face
A= Arm S= Speech T= Time |
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Tx for CVA includes:
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-early transport via EMS
-diagnostic imaging (CT, MRI) -tPA -Anticoagulants -Angioplasty/stent -Endarterectomy |
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When treating a CVA a ____ is done first to rule out _____.
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CT scan
hemorrhagic stroke |
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A ____ gives more precise information about location and structures surrounding the stroke.
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MRI
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A drug used to treat a patient who has had a stroke is ____.
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tPA
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tPA stands for
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Tissue Plasminogen Activator
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tPA must be given within...
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3 hours of onset of S/Sx
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tPA dissolves the ____ and therefore should not be given with a ______.
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clot
hemorrhagic stroke |
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tPA cannot be given if the BP is greater than _____ or if patient has had ____ therapy, recent fracture or bleeding ulcer.
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185/110 mmHg
anticoagulant |
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After giving tPA monitor the patient for improvement in
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BP and neuro status
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Potential complications of a CVA include:
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-thrombophlebitis
-pneumonia -UTI -seizures -decubiti -phlebitis |
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Nursing management after a CVA includes
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-AIRWAY
-positioning -encourage self-care -TCDB -swallowing -skin integrity -elimination -prevent subluxation of shoulder |
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3 medications given to assist with elimination are
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Ditropan, Urecholine and Detrol
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Things to remember about recovery from a CVA:
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-patient may have decreased LOC for days
-some tissue will recover when swelling subsides -swelling may take weeks/months to abate -significant progress for first 6 months |
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Problems that hamper CVA recovery include:
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-one sided neglect and denial
-depression -short attention span -falls -polypharmacy -repeated strokes -shoulder subluxation -progressive multi-infarct dementia -arthritis -renal failure d/t diabetes of HTN -cardiac problems -decubiti |
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A _____ is the outgrowth and weakening of the blood vessel.
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cerebral aneurysm.
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A cerebral aneurysm often ruptures because of ____ or ____ during exercise.
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wall thinning or increased blood flow during exercise
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S/Sx of a cerebral aneurysm are:
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-explosive h/a
-instant loss of consciousness -NV -photophobia |
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Treatment of a cerebral aneurysm includes:
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-aneurysm clip/stalk
-coil the aneurysm via cath thru groin |
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With a cerebral aneurysm the high crisis time for a rebleed is _____.
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48 hours to 7 days.
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A cerebral aneurysm is commonly called _____.
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blood on the brain
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____ is a common cause of sudden death for young adults.
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Cerebral aneurysm
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We can reduce the risk of bleeding in cerebral aneurysm patient by
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keeping them in a quiet calm environment, monitoring their BP and LOC.
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