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41 Cards in this Set
- Front
- Back
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Symptoms of Brain Attack (5)
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Sudden trouble walking, dizziness, loss of balance or coordination
Sudden severe headache w/o known cause Sudden confusion or trouble speaking or understanding speech Sudden numbness or weakness of face, arm Troubleseeing in one or both eyes |
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3 Steps to Recognizing a Stroke
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Ask Individual To:
Smile Raise both arms Speak a simple sentence |
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Stroke "SAFE" Signs
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Speech
Arms Face Eyes |
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Risk Factors of a Brain Attack (13)
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HTN
DM Heart Dz A fib Smoking Substance abuse (cocaine) ETOH Obseity Sedentary lifestyle Sleep Disorders Stress Elevated cholesterol/lipids/triglycerides |
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Symptoms of TIA (4)
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Deficits in:
Visual Motor Sensory Speech |
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What is Reversible Ischemic Neurological Deficit?
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Like TIA, but lasts longer (up to a week)
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Conditions that Cause Brain Attacks (4)
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localized hypoxia
global hypoxia Emobli thrombus |
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What is critical before giving drugs in a CVA?
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Differential diagnosis
CVA vs. lesion/trauma |
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CVA symptoms? (4)
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contralateral to injury
cranial nerves sam eside multiple emobli or anterior cerebral artery bilateral symptoms |
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What are two types of CVAs
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Ischemic and occlusive
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Two types of ischemic CVAs
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Thrombotic: slower process over time; ischemia progresses to symptoms
Hemorrhagic: vessel wall integrity disrupted, bleeding into brain tissue, vasospasm after rupture = ischemia, aneurysm, IC or SA hemorrhage |
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Types of Diagnostic Imaging for CVAs (4)
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CT Scan
MRI Ultrasound ECG |
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CVA Airway Medical Goals (4)
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Swallowing assessment
Upright in bed if awake Lying on side if unconscious Suction Equipment available |
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CVA Breathing Medical Goals (2)
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Monitor rate and depth of breathing
Monitor O2 Sat |
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CVA Circulation Medical Goals (2)
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Maintain cerebral blood flow (BP monitor & HOB low for flow, high to drain)
Watch for seizures, high ICP |
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CVA Medications for Ischemic and Hemorrhagic
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Ischemic: anti-platelet, anticoagulant, thrombolytic
Hemorrhagic: antihypertensive |
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Immediate Hemorrhagic Stroke Goals (4)
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Minimize further bleeding
Control Systolic BP (<130) Avoid anti-platelet & Anticoagulation drugs Restrict activity |
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Immediate Ischemic Stroke Goals (3)
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STOP clot from growing (heparin)
DISSOLVE clot (thrombolytics) REMOVE clot (surgery) |
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During what time frame should thrombolytics be given to receive the most benefit?
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3 hours of symptom onset
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Complications of Brain attack (Post-hospital)(6)
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Paralysis; muscle spasms
Sensor, motor, visual impairments Language, cognitive, memory changes Unstable emotions, fatigue Seizures (glial scarring) Psychological impacts |
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Complications of Brain Attack (In Hospital) (8)
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Cerebral Edema
Increased ICP Aspiration from swallowing difficulty (cranial nerves Hypoventilation, atelectasis, pneumonia DVT Pulmonary Emoblism UTI Skin breakdown, malnutrition, contractures |
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Acute Goals for CVA (3)
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Stabilize medical and neuro status
Initiate Plan to Prevent Complications & alleviate disabilities Acute-care nurses are the patient's FIRST rehabilitation nurse |
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Actions for nurses for CVA (7)
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Monitor vitals, know individual targets
Maintain hydration & nutrition Identify Risks & Prevent Complications: - Aspiration: swallow check 1st 72 hours - DVT & skin breakdown: move pt out of bed q4 - UTI: remove cath in 3 days - Contractures & extremities damage; support posture; extremeties in position of function) |
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What to teach a patient with homonymous hemianopsia
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Turn head towards deficit side
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Traumatic Brain Injuries Assessment
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- LOC, amnesia, SZ, visual disturbances, concomitant disorders (dysrhythmias, syncope, CVA)
- C-spine precautions - ABCs - CT scans, C-spine films - Check for CSF leaks (nose, ears) |
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What GCS score indicates Coma
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<7
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What symptoms may happen alongside concussions (6)
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Hypotension
Headache Irritability Confusion Unsteady Gait Visual Disturbances |
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Diffuse axonal injury: s/sx (5)
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Stretching/tearing neurons
LOC immediate and prolongued (>6 hrs) Cerebral Edema, brain stem injury possible |
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Contusion s/sx (9)
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Bruise @ site of injury w/ ALOC
hemiparesis Agitation Disorientation Combative Aggressive Aphasia Coma |
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Basilar Skull Fx s/sx (3)
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CSF leak nose, ears
Carotid hemorrhage Damage cranial nerves |
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Signs of Basilar Skull Fx (3)
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Battle's Sign
Raccoon Eye Halo Sign |
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IICP as a secondary brain injury d/t (7)
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Edema
Hemorrhge Hematoma Hydrocephalus Hypoxemia Hypercapnia Systemic Hypotension |
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Subdural hematomas are ___?
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Venous bleeds beneath dura - slow bleeding
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Different type of subdural hematomas (3)
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Acute - 48 hrs to develop
Subacute - 48 hours to 2 weeks Chronic - 2 wees to months |
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Intracerebral hemorrhage & s/sx (2)
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Blood accumulation within brain tissue d/t tearing small arteries and veins
Progresses to IICP relative to location of bleed |
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Subarachnoid hematoma/hemorrhage & s/sx
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d/t blunt trauma: vessels tear, hemorrhage
Nuchal rigidity Severe headache ALOC Contralateral hemiparesis Ipsilateral dilated pupil |
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Brain herniation in brain injuries
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downward shift of brain into brainstem d/t increased ICP
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Vasogenic edema in brain injuries
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Edema from the vessels
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Systemic HTN in brain injuries
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d/t body wanting to get blood to the brain
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Hydrocephalus in brain injuries
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d/t diation of the ventricles r/t impaired CSF absorption or obstruction to flow
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Complications of Brain injuries (7)
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Cerebral edema, IICP
Dysphagia, aphasia, coma Alterations in cognitive functions DI, SIADH, hyperthermia, seizures Headache, CSF leak Cranial nerve impairments Major Complication is IICP |
