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27 Cards in this Set
- Front
- Back
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stroke modifiable risk factors
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htn
cardiovascular disease smoking cholesterol obesity diabetes oral contraceptive use |
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stroke nonmodifiable risk factors
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african american, age 55
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majority of strokes are considered ___________
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ischemic
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usual causes of ischemic stroke
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htn
clots |
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types of ischemic stroke
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large artery thrombosis
small penetrating artery thrombosis cargiogenic embolism (a-fib) Lacunar stroke (chronic HTN) (HTN crisis) |
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is a type of stroke that results from occlusion of one of the penetrating arteries that provides blood to the brain's deep structures
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lacunar stroke
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an area of brain losses blood supply because of vascular occlusion
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cerebral intact
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weakness on one side
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hemiparesis
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difficult and deective speech due to impairement of tongue or other muscles essential to speech; mental fxn is intact
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dysarthria
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blindness on one-half of visual field
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hemianopsia
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paralysis of only one side of body
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hemiplegia
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temporary neurologic deficit resulting from a temporary impairment of blood flow
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TIA
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is a disturbance in brain function that lasts less than 1 hour and results from a temporary blockage of the brain's blood supply
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TIA
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code CVA means
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pt gets a CAT scan do determine if stroke is isch/hemmorhagic
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elderly patients usually have clots on their ____________
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carotid
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prevention of stroke
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low fat
low sodium periodontal ds prevention excercise |
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treatment/surgery for strokes
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carotid endarterectomy
anticoagulant therapy antiplatelet (plavic/ticlid) (ASA/Dipyridamole) statins (zocor) Anti-HTN |
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criteria for thrombolytic therapy
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age 18 yrs and older
acute isch.stroke assoc. with significant neurologic deficit symptom onset <3 hours before tx begins |
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contraindications for thrombolytic therapy
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intracranial hemorrhage
subarachnoid hemorrhage multilobar infarction on CT Hx of recent IC/IS surgery or serious head trauma within 3 months Hx of previous stroke within 3 mos uncontrolled HTN seizure at stroke onset internal bleeding or acute trauma intracranial neoplasm, AV malformation, aneurysm use of Coumadin with elevated INR or PT INR > 1.7 PT > 15 secs heparin within 48 hours, elevated PTT platelets <100,000 arterial puncture within 7 days |
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causes of hemmorrhagic stroke
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HTN
subarachnoid hemorrhage ruptured aneurysm amyloid angiopathy AVM (arterial venous malformations) anticoagulants |
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s/s of hemorrhagic stroke
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headache with focal neurological deficits with lapse into unresponsiveness
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clinical manifestations
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brain metabolism is disrupted
ICP compression or secondary ischemia vomiting |
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tx of hemorrhagic stroke
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bed rest
sedation O2 decrease ICP control HTN anticonvulsants prevent further bleeding |
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is an attentional problem to one side of their body. The patient may or may not have a loss of visual field
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visual neglect
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nsg care for stroke pts
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toileting (after breakfast)
fiber ROM neuro checks speech therapis consult pureed diet chin tuck swallowing method |
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electrolyte imbalance for stroke
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hyponatremia <135
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aneurysm precautions
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bed rest /HOB elevated
promote venous drainage avoid increasing ICP -- stool softeners, no Valsalva maneuver, neck flexion and rotation personal care and hygiene restrict visitors no stimuli prevent constipation dim the lights avoid ICU-itis orient to reality |
