CVA Questions and answers

Define the term infarction Answer- An infarction is. alone of tissue that is deprived of its blood supply Explain the difference between the two types of stroke and ischemic infarction and a hemorrhagic infarction Answer- Ischemic: Occlusion of a cerebral artery by either a thrombus or emboli Hemorrhagic: occurs from interrupted vessel integrity and bleeding occurs into the brain tissue Name 4 risk factors that contributed to Mrs. Kahn having a stroke Answer- - ethnicity, advanced age, diabetes, hypertension, obesity Which of these risk factors is the most significant for a stroke Answer- Hypertension What 3 risk factors does Mrs. Kahn have that are non-modifiable Answer- - Age - Ethnicity - Recent MI Name 5 clinical manifestations that can indicate a person is having a stroke. Answer- Confusion/change in mental status Difficulty Talking Dizziness, or a loss of balance or coordination Numbness or weakness of the face, arm, or leg, especially on one side of the body Sudden severe headache Trouble speaking or understanding speech Visual disturbances Based on Mrs. Kahn's deficits, which hemisphere has been affected by her stroke? Answer- Left What is tPA and why is it given for a stroke? Answer- Clot buster drug--given to break down clots and decrease the size of the stroke and improve overall functional outcome Why was TPA not an appropriate treatment option for Mrs.Kahn Answer- Blood pressure of 190/114 Time lapse of greater than 3-4.5 hours since the onset of her symptoms. What does the acronym FAST stand for Answer- Facial drooping Arm or leg problems Speech problems Time is brain call 911 What is the difference between dysarthria and dysphasia? Answer- Dysarthria is difficulty with speech due to paralysis of the muscles that control speech Dysphasia is difficulty with speech due to speech center in brain being affected After spasticity what musculoskeletal complication occurs with stroke? Answer- Contractures What cardiac rhythm is a common risk factor for acute ischemic stroke? Answer- Atrial fibrillation What is the medical name for drooping eyelid? Answer- Ptosis The patient is most at risk for increased intracranial pressure resulting from edema during the first __________ to ______ hours after onset of the stroke? Answer- 24-48 After stroke, the HOB should be kept at ______degrees to prevent a decreased blood flow to the brain Answer- 25-30 degrees True or false, when communicating with a patient with expressive aphasia, it is best to use yes and no questions? Answer- False-- because they often give automatic responses that may be incorrect The affected flaccid arm of a stroke patient should be supported to prevent this complication. Answer- Shoulder subluxation What health care team member performs a bedside swallowing screening and evaluation? Answer- Speech-language pathologist True or False? As many as 50% of patients were malnourished at 2-3 weeks after a severe stroke. Answer- True What is a commonly used assessment tool that nurses complete as soon as possible after a stroke patient arrives in the ER? Answer- The national institute of health stroke scale What is the most common artery involved in an embolic stroke? Answer- Middle Cerebral Artery What is the usual site of an emboli that cause an embolic stroke? Answer- The heart What term is used by the National Stroke Association to better describe a stroke? Answer- Brain attack What diagnostic test is done when a stroke patient comes in to determine if the stroke is hemorrhagic? Answer- Computed tomography (CT SCAN) What is the most common type of incontinence with stroke patients Answer- Urge incontinence What respiratory problem occurs from aspiration? Answer- Pneumonia With which type of aphasia does the patient have trouble understanding but can speak fairly well? Answer- Wernicke's aphasia Which is best for protecting the brain during a stroke? Hypothermia or hyperthermia? Answer- Hypothermia When is the onset of symptoms for a stroke determined? Answer- Time the patient was last seen normal? (LSN) What does agnosia mean? Answer- Inability to recognize familiar objects, faces, or sounds Which of the following is a nonmodifiable risk factor for stroke? Hypertension, sickle cell disease or obesity? Answer- Sickle cell disease Name 1 ethnic group that has a high risk of stroke? Answer- African Americans Alaska Natives American Indians What is a TIA? Answer- Brief episode of neurological dysfunction typically 1-2 hours What are the 3 essential volume components in the skull? Answer- Brain tissue, blood and CSF What are the highest and lowest scores on a Glasgow Coma Scale? Answer- Highest 15 Lowest 3 What 3 indicators are evaluated in a Glasgow Coma Scale? Answer- Opening of eyes Best verbal response Best motor response How is consciousness measured? Answer- Glasgow coma scale What level of consciousness means only vigorous and repeated stimuli will arouse the patient? Stuporous or Obtunded Answer- Stuporous What is included in a basic neurotransmitter-assessment Answer- LOC, orientation, motor response, pupils (size and reaction) Discuss 3 nursing interventions to prevent aspiration Answer- Sit at 90° ▪ check laryngeal elevation ▪ chin tuck. ▪ double swallow ▪ keep glass ¾ full▪ thickened liquids▪ schedule a rest period before eating ▪ keep upright 30-45 min after eating ▪ place food on affected side of mouth ▪ no straws What does the acronym FAST stand for? Answer- Facial drooping---arm weakness—speech problems—time to call 911 What is the first step in beginning a bladder training program Answer- Offer toiling at least every 2 hours A patient with a stroke on this side of the brain has poor judgment and may forget to call to get OOB Answer- Right What is hemianopsia Answer- Blindness in half of the visual field Give an example of one triggering technique to facilitate voiding in a stroke patient who has an intact bladder reflex Answer- Stroking the medial aspect of the thigh Pinching the area above the groin Massaging the penoscrotal area Pinching the posterior aspect of the glans penis Digital anal stimulation What is post-void residual Answer- Amount of urine remaining in bladder within 20 minutes after voiding What is the best intervention to prevent skin breakdown? Answer- Frequent position changes What is the difference between paresis and paralysis Answer- Paresis is weakness and paralysis is absence of movement As part of the rehabilitation team, who works to develop the stroke patient's fine motor skills? Answer- Occupational Therapist