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Stroke protocols
Alberta Provincial Stroke Strategy
| Question | Answer |
|---|---|
| What is the frontal lobes responsible for? | Initiation, Judgement, Regulation of behavior/personality, problem-solving and attention |
| What 2 arterties supply the frontal lobe? | The middle and anterior cerebral arteries |
| What 2 arteries supply the temporal lobe? | The middle and posterior cerebral arteries |
| What is the temporal lobe responsible for? | Memory, Language |
| What is the parietal lobe responsible for? | Judging position, Tactile sensation, |
| Stroke is highly associated with what? | Cognitive changes and dementia diagnosis |
| What fraction of strokes see a cognitive improvement? | 1/5 |
| What is attention? | The ability to attend and process information |
| What abstact reasoning? | The ability to see implied relations or symbolic meaning |
| What is judgment? | The ability to consider probable outcomes of actions |
| What is insight? | The ability to accurately assess one's abilities |
| What is memory? | The ability to encode and retrieve information |
| Hypertension increases the risk of stroke how much? | 4X |
| After a stroke, decreasing hypertension, decreases the risk of what? | Cognitive decline |
| What reading is considered a sign of hypertension? | Greater than 140/90 |
| What is considered hypertension for a patient with renal failure or diabetes? | 130/80 |
| What are symptoms of Cerebral edema after a stroke? | Worstening change in level of conciousness, nausea/vomiting, decreased pupillary response |
| What percentage of stroke patient's have dysphagia? | 55% |
| How can OT assist a patient with dysphagia? | Use feeding equipment, eliminate tablespoons and large forks (limit to smaller utensils), ensure upright posture |
| What precautions need to be followed for a hemiparetic shoulder? | Avoid pulling or lifting shoulderHow |
| How can a hemiparetic arm be supported? | Sitting-lab tray, arm rest Laying- with pillows Standing-sling, or pockets |
| What kind of therapies should be performed with a hemiparetic limb? | Pain free range of motions, motions that use active range |
| What is hemorragic transformation? | Bleeding into the brain 1-2 days after a stroke |
| What are signs of hemorragic transformation? | Sudden progressive worstening of conciousness, pupillar response, vitals, sensory or motor symptoms |
| Pt's with dysphagia should sit at what angle? | 90 degrees |
| How should Passive Range of motion (PROM) be performed with a hemiparetic shoulder? | It should be limited to 90 degrees of flexion or abduction if the scapula doesn't rotate |
| What is aphasia/dysphasia? | Inability to use language |
| What is dysarthria? | difficulty pronouncing words due to lack of speech muscle control |
| What is dyspraxia? | Only automatic speech Hi, Bye, your welcome, swears, remain but otherwise control isn't present. |
| How is speech different than language? | Speech is the use of the muscles, Language is the dictionary of words. |
| What are the two types of aphasia? | Expressive (left damage to BROCA's area) Receptive can't understand words (right Wernike's area) |
| What two tone changes are common in stroke? | Low tone-flaccidity High tone- spacticity |
| When is the soonest a stroke survivor can/should be mobilized? | As soon as their symptoms are no longer worstening |
| What techniques are often effective for communicating with a person with a stroke (3)? | 1. Yes/No Questions. 2. Pointing to key words (eg. Yes/No/maybe) 3. Guestures |
| What 3 visual issues are common to stroke survivoers? | 1. Diplopia 2. Hemianopia 3. Visual acuity |
| What is hemianopia? | Loss of vision on one half of the body |
| How should changes in visual acuity in stroke survivors be treated ? | referral to an optometrist |
| How can double vision or hemianopsia be treated? | teach scanning, refer to an optometrist |
| Unilateral neglect is what? | Inability to attend to objects (they don't exist) on one side |
| What are treatments for unilateral neglect? | setting up stimulation at midline |
| What is apraxia? | Engaging in inappropriate motor activities or sequences |
| What are 3 methods to deal with apraxia? | 1. Diagrams of how to perform an activity 2. Use verbal cues NOT demonstration 3. Hand over hand guidance |
| What percentage of stroke survivors struggle with incontinence? | 40-80% |
| What are the causes of incontinence in stroke? | Inability to reach the washroom (environment and mobility), Decreased sensation, Decreased muscular use |
| What stategies can be used to help manage incontinence? | Schedualed voiding, Pelvic exercises, Catheter removal ASAP, Compesatory Tech |
Created by:
swcherry
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