102 Test 3 Cva

Front 1

what vessel usually breaks going to the brain that causes a stroke?

Back 1

carotid artery

Front 2

the main thing that causes a stroke is ...

Back 2

HTN

hypertension

Front 3

what is a vasospasm?

Back 3

cerebral artery shuts off for a sec. and the opens up causing a TIA ( a mini stroke )

Front 4

CVA is called ...

Back 4

Cerebro vascular Disease

Front 5

Again, things that cause CVA are

arteriosclerosis (plack buildup)
hypertensive changes
Vasospasm (on/off thing in brain
Inflammatin (swelling/coagulation in arteries in the brain
Embolism. what is an Embolism?

Back 5

blood, air, or fat plack travels to lungs, heart, or brain. A fat emboli can even get to the kidneys, heck anywhere in body

Front 6

it takes about 4 minutes for a blood shut off to do irrepruble damage, like to the brain. So, a stroke will always result in ...

Back 6

permanent disability
and permenant brain damage
*****************************
3rd largest cause of death in US

Front 7

TIA means transient Eschemic Attack

what is this?

Back 7

TIA used to be called a mini stroke...*****************
DEF: TIA=a stroke that resolves itself in 24 hours.
********************************
can be a warning sign of an impending stroke. So TIA says "something has happened! Something happened, from lipids, a spasm, a tiny clot went thru, (a clotting problem, or a tiny embolism) or maybe a cardiovascular problem. Trauma to a long bone, or marrow or fat from that got loose. A warning sign bigger thing is going on.

Front 8

ataxia means

Back 8

ability to move muscles

so muscle movement

Front 9

what does paresthsias mean

Back 9

not normal feelings like tinglings bugs crawling on you

Front 10

TIAs *************************
what ae need to know is that they are RAPID ONSET
sO... A PT SAID "i PASSED OUT, DOWN AND THEN FELT TINGLES ON MY LEFT SIDE AND MY SPEECH WAS SLURRED BUT THAT ALL WENT AWAY YESTERDAY. WHAT WOULD THE DOCTOR ORDER?

Back 10

A CT CAT SCAN

AN MRI
IT CAN LOOK AT THE BRAIN AND CARATOIDS.
MAYBE ORDER A CARTIAC WORKUP

Front 11

SO WE ARE DOING A HISTORY OF THIS PT, WHAT DO WE LOOK FOR?

Back 11

Hx OF SMOKING
ALCOHOL
COCAINE (IN THE YOUNG& TIAs)
SAY WHAT WERE YOU DOING WHEN THIS HAPPENED. HOW LONG DID IT LAST? YOU SAID YOU WERE NUMB ON THE LEFT SIDE? DIFFICULTLY WALKING? SO ONSET DURATION INTENSITY OF THIS EVENT FIRST TIME THIS HAS HAPPENED TO YOU?

Front 12

SO THE PT COMES INTO THE ER AND TELLS ALL THIS STUFF. THE MD ORDERS A MRI, CT SCAN, LOOKING THE HEART FOR THINGS LIKE AF OR ATRIAL FIBLUATION WHY? THE HEART?

Back 12

THE VALVES B/C LOOKING FOR ATRIAL FIBULATION B/C VALVE Dx CAN CAUSE CLOTS SO THEY WILL DO DOING CARDIO WORKUPS AND PUT THEM ON
HEPARIN IMMEDIATELY B/C THEY DON'T WANT THE BLOOD TO CLOT
WHEN SENT HOME MIGHT GIVE THEY PUT THEM ON PLAVIX,ASPIRIN, TO KEEP CLOTS FROM FORMING

Front 13

WHAT WOULD A NURSE ASK SOMEONE WHO JUST HAD A TIA AND IS GOING HOME?

Back 13

DO YOU LIVE ALONE?
DO YOU HAVE STAIRS?COULD BE GOOD
DO YOU HAVE A PHONE?
ARE YOU RETIRED?
SAFETY ISSUES

Front 14

what kind of labs would we be looking for with TIAs?

Back 14

lipid count
platlets for clotting factors
we want a complete blood count
a glucose level
bleeding time (clotting factors)

Front 15

we do a blood glucose and its normal what then?

I mean the symptoms are like hypoglycemia and passed out

Back 15

it isn't diabetes related to the episode so it could of been a TIA
but we need to rule out low blood sugar.

Front 16

what does diabetes or hi blood sugar have to do with TIA so what does hi blood sugar and clotting have to do w/ this?

Back 16

sticky blood! RBCs are sticky
they may do a cerebrial angiography (angiogram) watch how die profuses thru the brain
if they throw one clot it can happen again so where would we look? in the lungs? Ausculate for anxiety from decreased oxyngenation? get an IV started? for immediate IV access!

Front 17

so we have the pt in front of us we need serial neurological exams to establish ...

Back 17

a basline
tests like PERRLA
vital signs
neuro ck 12 cranial nerves for fields of vision

Front 18

why would a md put a pt on ace inhibitors?

Back 18

its a anti hypertensive med

it dialates vascular system

Front 19

pt will be put on anticoagulants
put on antihypertensives ...
what are some nursing Dx?

Back 19

ineffecive coping "i just had a little fall, im ok now"
fall risks
knowledge deficit is a biggy

Front 20

so MD might order a carotid Endarterectomy what is this

Back 20

rooter router surgery to remove plaque. its dangerous so they put it off to last b/c it can cause a stroke

Front 21

what would be complications from a Carotid Endarterectomy?

Back 21

stroke
cranial nerve injury
infection
hematoma of wound
carotid artery disruption

Front 22

so the nurse management part
we will:
close cardiac monitoring (ask if there is a Hx of coronary artery disease)
ck their tongue...why?

Back 22

hypoglossal nerve & swallowing
cking the cranial nerves ...remember A&P

Front 23

the risk factors for this TIA stroke are like:
hypertension in blacks
hi cloresterol & hi triglyerides
aging
any disease process
what else?

Back 23

diabetes
cardiovasular Dx
obesity
elevated hematocrit
0ral contraceptives
alcohol use

Front 24

ischemic something w/ a stroke

ischemic is kind of like hypoxia but instead of lack of o2 to tissue it means ...

Back 24

total blockage or a lack of blood flow to an organ. this can happen from TIA.Ischemica results from a thrombus (clot) in a blood vessel in the brain or cerebral embolism (a clot of stuff like air or fat
Ischemia to the brain is an arterial spasm that diesn't release

Front 25

what is multi infarct dementia?

Back 25

from lots of small strokes which cause severe damage over time causing dementia
symptoms are:
HALLUCINATIONS LIKE SIGHT,HEARING,FEELING ON THE SKINOR SMELL

Front 26

there is hemorrhagic in a stroke
results from:

Back 26

a rupture of a cerebral blood vessel w/ bleeding into the brain tissue or spaces around there

Front 27

hemorrhagic strokes:
bleeding in the epidural or subarachnoid or intracerebrally
where is this bleeding in the epidural?

Back 27

b/t dura mater & skull &
b/t periosteum & dura

Front 28

hemorrhagic stroke in the subdural hemorrahge
bleeding b/t dura matter & arachnoid membrane
subdural is like a edidural except involves a brigding ..

Back 28

vein is torn

Front 29

hemmorrhage strokes

intracerebral hemmorrhage is ...

Back 29

bleeding in the brain or cerebral tissue w/ displacement of the surrounnding tissues

common in pts w/ HTN & cerebral artherosclerosis

Front 30

manifestations of CVA:
homonymous hemianopsia
what is this

Back 30

loss of half of visual field
loss of peripheral vision
diplopia-double vision

Front 31

stroke folk can experience paresthesia. what is this?

Back 31

unpleasent sensation such as numbness or tingling, feeling hot water or creepy crawly all over

Front 32

cognitive deficits:

memory loss
decreased attention span
what about verbal deficits?

Back 32

expressive aphasia = can't express to YOU
receptive aphasia=can't understand you
global aphasia=having both

Front 33

emotional deficit
name a few

Back 33

withdrawal
depression
spontaneous crying

Front 34

THE LEFT HEMI STROKE

yeilds:
r sided paralysis
r visual field deficit
aphasia = unable to communicate
altered intellectual ability
slow cautious behavior
any thing else?
*****************************

Back 34

needs lot of encouragement
incidence of depression-cry b/c depressed

Front 35

what we can do and not do to stop strokes
what can we not stop?

Back 35

gender=higher in males
age-increases w/ age
race=blackes get this
heredity=due to family incidence of risk factors: diabetes,cardiovascular disease