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Stack #38899
RRC Maintenance - CVA
| question | answer |
|---|---|
| Where can an hemorrhagic stroke occur? | anywhere within the cerebral vasculature, however most common in Circle of Willis |
| Hemorrhagic stroke | results fom bleeding into the brain tissue itself or into the subarchnoid space or ventricles |
| intracerebral stroke | bleeding within the brain caused by rupture of a vessel |
| subarchnoid stroke | intracranial bleeding itno CSF-filled space commonly caused by a cerebral aneurysm |
| ischemic stroke | results from indequate blood flow to brain from partial or complete occlusion of artery |
| thrombotic stroke | occurs in relation to atherosclerosis and formation of clot that narrows the lumen of the artery |
| embolic stroke | occurs when an embolus lodges in and occludes a cerebral artery, resulting in an infarct and edema to area of surrounding tissue; typically lodges where the vessel narrow or bifuricates |
| types of ischemic stroke | thrombotic; embolic |
| types of hemorrhagic stroke | intracranial; subarachnoid |
| What is a TIA? | simular to a CVA, however short duration and LOC stays intact, temporary with residual neurological deficits |
| What body functions can be affected by CVA? | motor activity, elimination, intellectual functioning, spacial-perceptual alterations, personality, affect, sensation, communication |
| clinical manifestation of hemorrhagic stroke | severe occipital or nuchal pain, vertigo/syncope, epistaxis, nausea/vomiting, retinal hemorrhage, neurological deficits, decreased LOC |
| clinical manifestation of ischemic stroke | headache with decreasing LOC and neurological deficits dependent upon area of brain affected |
| signs of right sided CVA | left-sided hemiplegia, left-sided neglect, spacial-perceptual deficits, tends to deny/minimize problems, rapid performance, short attention span, impulsive, safety problems, impaired judgment, impaired concept of time |
| signs of left-sided CVA | right sided hemiplegia, impaired speech, language aphasia, impaired left-right discrimination, slowed performance, cautious, aware of deficits, depression, anxiety, impaired comprehension r/t language and math |
| akinesia | loss of skilled voluntary movement |
| possible motor function losses in CVA | impairment of mobility, respiratory function, swallowing/speech, gag reflex, self-care abilities |
| aphasia | total loss of comprehension and use of language as a result of damage to dominant hemisphere |
| global aphasia | all communication and receptive function is lost |
| receptive aphasia | neither sound of speech or meaning are understrood resulting in impairment of spoken and written language; results from damage to Wernicke's area |
| expressive aphasia | difficulty speaking and writing; results from damage to Broca's are |
| dysphasia | difficulty r/t comprehension and use to language |
| fluent dysphasia | speech is present; however little meaningful communication |
| non-fluent dysphasia | minimal speech activity with minimal speech that requires obvious effort |
| dysarthria | disturbance in muscle control of speech and may involve pronounciation, articulation and phonation. Does not affect meaning or comprehension of communication |
| affect | may have difficulty controlling emotions where emotional response may be exaggerated or unpredictable |
| impairment of left-sided intellectual function | more likely to result in memory problems r/t language |
| impairment of right-sided intellectual function | impulsive and moves quickly |
| agnosia | inability to recognize object by sight, touch or hearing |
| apraxia | inability to carry out learned sequence of movements on command |
| diagnostic tests for CVA | CT scan, MRI, CBC |
| non-modifiable risk factors for CVA | age, family history, male sex, prior TIA, African descent |
| modifiable risk factors for CVA | cardiac arrthymias, cardiomyopathy, DM, excessive ETOH/illegal drug use, history of migranes, dyslipidemia, HTN, coagulation disorders, polycythemia vera, hypothyroidism, dehydration, OCP, smoking, vasculitis, sudden discontinuation of BP meds |
| Why is D5W avoided when providing IV therapy to an individual with a CVA? | hypotonic and may further increase cerebral edema and increase intracranial pressure |
| Why might an individual with a CVA not be able to maintain a patent airway? | decreased LOC or decrease/absent gag/swallowing reflexes |
| How should one with a hemorrhagic stroke be positioned? | elevate HOB to decrease pooling of blood in the head and to decrease IICP |
| How should one with a ischemic stroke be positioned? | HOB flat to promote cerebral perfusion |
Created by:
bella83
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