Card Set Information
what is the definition of CVA
disruption of blood flow in the brain resulting in loss of function
how quickly must thrombolytic therapy be started when the patient has a CVA?
3 hrs or fewer to decrease brain damage
what are some causes of stroke?
hemmorhage, aneurysm, areteriovenous malformation.
what does ipsilateral and contralateral mean?
ipsilateral- same side
contralateral- opposite side
common s/sx of strokes.
weakness of the face arm or leg
on one side of the body(hemiparesis)
loss of speech(aphagia)
makes verbal substitutions(apraxia)
what is homymous hemianopsia?
temp or permanent loss of half of visual field.
what is agnosias?
inability to recognize familiar objects
if the frontal lobe has a lesion what are expected cognitive problems?
-frontal lobe is responsible for learning capacity and memory
-limited attention span
what is the DASH diet?
high fruit/vegetables, low fat dairy products and protein
what does the CT scan do when helping identify type stroke?
if it is ischemic or hemorrhagic
what does a EKG and carotid US do?
is its ischemic, emboli or thrombi
name some modifiable risk factors of ischemic stroke.
what are medical tx for ischemic stroke?
if cardioembolic storke- warfarin with target INR 2-3
ASA, plavix- reduce cerebral infarction
statins- reduce coronary events and strokes
what is t-PA?
-recombinant copy of thrombolytic substance made in the body.
-must be done within
-revascularization after 3 hours leads to cerebral edema and hemorrhage
what is the dosage of t-PA? How is it given?
-max is 90 mg
-10% IV bolus in 1 minute than the rest given via IV infusion for 1 hr
what is the most common side effect of t-PA
bleeding( most common)
management of ischemic stroke without t-PA
-osmotic diuretic(mannitol), lower ICP
-elevate HOB, promote venous drainage
-hemicraniectomy for increased ICP
monitor BP and neurological less than 180/100, this reduces potential chance of bleeding
what are you monitoring for in the acute phase?
-stiffness or flaccidity of neck
nursing intervention r/t immobility
-change position q2 hrs to prevent edema and bed sores
-ROM 4-5 x a day
-give bedpan once pattern observed
-constipation tx with water and fiber
- training program and have positive feedback to pt
nursing intervention r/t sensory
1st time approach unaffected side than next time approach from affected side
- remind pt of other side
-nutrition- may cause dribbling or pooling in mouth
dysphagia- difficult to swallow
nursing intervention r/t communication
- dont finish sentences for them
- speak slowly and use consisten language, one instruction at a time
what is hemorrhagic stroke?
bleeding in the brain tissue or subarachnoid space
what is more common ischemic or hemorrhaic stroke
what is AVM?
-abnormality in emmbroynal phase
- tangle of arteries and veins
-absence of capillary bed leads to rupture
what is subarachnoid hemorrhage?
-may be r/t AVM, htn, trauma
most common cause is bleeding into circle of willis
-dilation of the walls of a cerebral artery
before recieving t-PA pt should be assessed for NIHSS
score of over 22 is not eligible
what is the main surgical procedure for managing TIA
left side stroke
affects right side
altered intellectual ability
slow, cautios behavior
right side stroke
spatial perceptual deficits