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2010-03-26 14:04:43
MS2 Exam 3

Show Answers:

  1. Why is atrial fibrillation a risk factor for stroke?
    Clot formation
  2. If going through an ischemic stroke why do we not want to lower the BP?
    Decrease perfusion
  3. 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
  4. TIA
    Reversible or Irreversible?
    Resolves within?
    Sign of impending?

    24 hours

  5. What are the clinical presentations of a TIA?
    • Amaurosis Fugas (losing vision in one eye)
    • Weakness
    • Aphasia
    • Diplopia
    • Vertigo
    • Syncope
    • Reflex Asymmetry
  6. Be sure to not confuse a TIA with what other diagnosis?
    • Migraine
    • Partial Seizure
    • Subdural Hematoma
    • Brain Tumor
    • Cardiac Syncope
    • Hypoglycemia
    • Encephalitis
  7. A small area of infarct the blocks a penetrating blood vessel is?
    Lacunar Stroke

    Can be asymptomatic and lead to dementia
  8. Hemorrhagic Stroke
    Risk factors?
    Very poor

    Hypertension, Aneurysms, Trauma, Tumor, AVM
  9. This problem has a sudden onset, severe headache, N&V, decrease LOC and elevated BP
    Intracerebral Bleed
  10. This problem has a decrease in LOC, N&V, focal neuro deficits and is usually coined the "worst headache of my life"
    Subarachnoid Hemorrhage
  11. How to care for a stroke?
    • ABC's
    • Know time of onset
    • Vitals
    • Seizure precautions
  12. The most important assessment for a stroke is
  13. tPA must be initated within _________ hours
  14. tPA is contraindicated with ___________

    Those people are given a _______ hour window.
    80y/o+ who are on anticoagulants, diabetics or had previous stroke

    3 hour
  15. Once tPA is initiated, the nurse must monitor closely for
  16. What is the best diagnostic test for a stroke?
    Non-Contrast CT
  17. Treatment of Ischemic Stroke
    • Heparin Drip
    • Antiplatelets
    • Coumadin for A-Fib (Target INR: 2-3)
    • Carotid Endarterectomy
    • Carotid Stenting
    • MERCI Retriever
  18. A speech deficit usually results from a ________ CVA
  19. What is difference between non-fluent and fluent aphasia?
    Non-fluent - slow, can't get words out

    Fluent - freely speaking but not making sense
  20. 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."
  21. What is homonymous hemianopsia?
    Loss of one side of visual fields in both eyes
  22. Right Side CVA presentations
    • Left side paralysis
    • Fall Risk
    • Spatial perceptual deficits
    • Denial
    • Impulsive
    • Impaired judgment
  23. Left Side CVA presentations
    • Right side paralysis
    • Language deficit
    • Slow/cautious behavior
    • Aware of deficits
    • Depression
    • Impaired comprehension
  24. Damage to which part of the brain is responsible for expressive aphasia?

    A) Wernicke's Area
    B) Parietal Lobe
    C) Broca's Area
    D) None of the above
    C) Broca's Area
    (this multiple choice question has been scrambled)
  25. Which of teh following patients is at higher risks for falls?

    A) Left brain CVA
    B) Both equally at risk
    C) Right brain CVA
    C) Right brain CVA
    (this multiple choice question has been scrambled)
  26. 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:

    A) He is a candidate for tPA
    B) He is too old to receive tPA
    C) He is not a candidate for tPA
    D) He needs a CT and thorough history to determine eligibility for tPA
    D) He needs a CT and thorough history to determine eligibility for tPA

    (since it started 30 minutes ago)
    (this multiple choice question has been scrambled)