Why is atrial fibrillation a risk factor for stroke?
If going through an ischemic stroke why do we not want to lower the BP?
What are the two types of stroke and what are their sources?
Thrombotic - plaque ruptures and thrombus occludes vessel
Embolic - A-fib, MI, Valvular diseases
Reversible or Irreversible?
Sign of impending?
What are the clinical presentations of a TIA?
- Amaurosis Fugas (losing vision in one eye)
- Reflex Asymmetry
Be sure to not confuse a TIA with what other diagnosis?
- Partial Seizure
- Subdural Hematoma
- Brain Tumor
- Cardiac Syncope
A small area of infarct the blocks a penetrating blood vessel is?
Can be asymptomatic and lead to dementia
Hypertension, Aneurysms, Trauma, Tumor, AVM
This problem has a sudden onset, severe headache, N&V, decrease LOC and elevated BP
This problem has a decrease in LOC, N&V, focal neuro deficits and is usually coined the "worst headache of my life"
How to care for a stroke?
- Know time of onset
- Seizure precautions
The most important assessment for a stroke is
LEVEL OF CONSCIOUSNESS!
tPA must be initated within _________ hours
tPA is contraindicated with ___________
Those people are given a _______ hour window.
80y/o+ who are on anticoagulants, diabetics or had previous stroke
Once tPA is initiated, the nurse must monitor closely for
What is the best diagnostic test for a stroke?
Treatment of Ischemic Stroke
- Heparin Drip
- Coumadin for A-Fib (Target INR: 2-3)
- Carotid Endarterectomy
- Carotid Stenting
- MERCI Retriever
A speech deficit usually results from a ________ CVA
What is difference between non-fluent and fluent aphasia?
Non-fluent - slow, can't get words out
Fluent - freely speaking but not making sense
What is the difference between Broca's area and Wernicke's area?
- Broca - Expressive aphasia
- EX: "Son ... University ... Smart ... Boy ... Good ... Good ..."
- Wernicke - Receptive aphasia
- EX: "I called my mother on the television and did not understand the door."
What is homonymous hemianopsia?
Loss of one side of visual fields in both eyes
Right Side CVA presentations
- Left side paralysis
- Fall Risk
- Spatial perceptual deficits
- Impaired judgment
Left Side CVA presentations
- Right side paralysis
- Language deficit
- Slow/cautious behavior
- Aware of deficits
- Impaired comprehension
Damage to which part of the brain is responsible for expressive aphasia?
B) Broca's Area
Which of teh following patients is at higher risks for falls?
C) Right brain CVA
John Smith is an 85y/o male who began experiencing right sided weakness and difficulty speaking 30 minutes ago. His BP is 160/90. He is not on anticoagulants. Which of the following are true:
B) He needs a CT and thorough history to determine eligibility for tPA
(since it started 30 minutes ago)