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What is a CVA?
- Cerebrovascular Accident = stroke = blockage of the arteries supplying blood to the brain resulting in permanent brain damage
- CC = one sided weakness/numbeness, changes in speech/vision
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Scribe alert for CVA?
- always document date and time they were last known well at baseline
- tPA can be administered if onset was within 3 hrs, but after 3 hrs doesn’t make much of a difference
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What is a TIA?
- Transient Ischemic Attack = vascular changes temporarily deprive a part of the brain of oxygen
- symptoms usually last less than 1 hr
- CC = short term changes in speech, vision, strength, or sensation
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Scribe Alert for TIA
- TIAs are known as mini strokes
- symptoms usually last less than 1 hour and there is no permanent brain damage
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What is a brain bleed called?
- Hemorrhagic CVA = traumatic or spontaneous rupture of blood vessels in the head -> bleeding in the brain
- CC = sudden onset of thunderclap, worst headache of their life
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How is a hemorrhagic CVA diagnosed?
- CT Head
- LP (lumbar puncture)
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what is tPA?
worlds best blood thinner
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What is meningitis?
- an inflammation + infection of the meninges (the sac surrounding the brain and spinal cord)
- CC = headache and neck pain
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How is meningitis diagnose?
LP (lumbar puncture)
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Effects of spinal cord injury?
- may create bilateral extremity weakness
- neck pain or back pain
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Scribe Alert for spinal cord injury
during initial physical exam, the spine is often immobilized with a C-collar and backboard — have to document
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How are spinal cord injuries diagnosed?
- CT cervical spine
- CT thoracic spine
- CT Lumbar spine
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What is a SZ?
- seizure = abnormal electrical activity in the brain leading to abnormal physical manifestations
- usually caused by epilepsy, alcohol withdrawal
- CC = seizure activity, syncope
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What kind of medications are used for seizures?
- neuromodulating meds
- Keppra, Depakote
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What is Bells Palsy?
- inflammation or viral infection of the facial nerve causes one sided weakness of the entire face
- facial droop, sudden onset
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pertinent negatives for Bells Palsy?
- no extremity weakness
- no vision changes or aphasia
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What is an HA?
Headache/Cephalgia = pressure, throbbing
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Pertinent negatives for HA?
- no fever
- no neck stiffness
- no numbness/weakness
- no changes in speech/vision
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What is AMS?
- altered mental status
- most common causes are hypoglycemia, infection, intoxication, neurological
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How is AMS different from Focal Neuro deficits?
- AMS - generalized, affects the whole brain/body
- Focal Neuro deficits - localized to one specific area
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What is the medical term for fainting?
- Syncope
- temporary loss of blood supply to the brain resulting in loss of consciousness
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What is the medical term for dizziness?
- Vertigo
- could be caused by damage in a specific center of the brain (possible CVA) or a harmless problem of the inner ear (benign positional vertigo)
- CC = room spinning, feeling off balance, worsened with head movement
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