Patho
A sudden disruption of blood flow to the brain that impairs neurological function.
What is a stroke/ CVA?
Survey used to assess severity CVA.
What is NIHSS?
(The higher the score the more severe the stroke is).
Untreated A-fib increases the likelihood a client may experience this type of stroke.
What is an ischemic stroke?
This acronym is used to teach clinical staff and provide patient education to recognize clinical symptoms of a stroke.
What is F.A.S.T?
A class of medication used for stroke prevention.
What are anticoagulants?
Cause by a thrombus or emboli that occludes cerebral blood flow.
What is an ischemic stroke?
The term for the inability to express one's self and the area most likely affected causing this condition.
What is aphasia?
S/S of ischemic stroke.
What are numbness or weakness of the face, arm, and or leg that is usually one-sided?
(Also, changes in mental status, difficulty speaking or understanding speech (aphasia).
The ED nurse prepares a client with s/s of CVA immediately for this diagnostic test.
What is a CT scan?
To decrease ICP, the nurse would expect to administer this diuretic.
What is an osmotic diuretic / Lasix/ Mannitol?
Number one cause of CVAs.
What is chronic hypertension?
The two forms of hemorrhagic strokes.
What are intracerebral and subarachnoid hemorrhage?
Abuse of this illicit drug increases the chance of an ischemic stroke.
What is cocaine abuse?
The patient who is experiencing an ICP should be placed into this position.
What is elevate the head of the bed to a 30 degree angle?
This medication class is used world wide to prevent vasospasms in post hemorrhagic stroke patients.
What are calcium channel blockers (CCBs)
(Nimotop/nimodipine)
Major fuel source for nervous system.
What is glucose?
The nurse expects to hear what subjective data from a patient experiencing a SAH (subarachnoid hemorrhage).
What is a severe headache/ Thunder clap "worst headache of my life"
Examples of modifiable risk factors.
What are hypertension, diet, and smoking?
The nurse notices a patient diagnosed with a hemorrhagic CVA starting to breathe irregularly with notable tachycardia then immediately goes bradycardic. These two symptoms are indicative of this.
What is Cushing's Triad?
A patient has been prescribed Eliquis after suffering an ischemic CVA. The nurse should notify the provider if the patient experiences these adverse effects of this medication.
What are low platelet counts, increased PTT/ INR, petechiae, easy bruising, hematuria, hemoptysis, melena, and coffee ground emesis (hematemesis)?
After a class, a female instructor c/o dizziness, headache, and right arm weakness. The school nurse recommends she goes to the Emergency department. When the instructor arrives in ER, the symptoms has resolved. Explain what has happened.
What is the instructor was experiencing TIA (transient ischemia attack)?
How often would you expect to do neuro assessments on a patient who is immediately post op from a craniectomy to relieve cerebral pressure?
What is every 15-30 minutes? Or per unit policy
To ensure adequate cerebral perfusion, the nurse should monitor ____ when taking blood pressure.
What is mean arterial pressure?
A preceptor nurse intervenes when a senior nursing student assists a client with right hemiparesis to transfer from bed to chair if the nurse concludes which action is BEST to address the needs of the patient.
What is help to stabilize the patient weakened knee during transfer?
(This helps with stability and helps decrease falls risk).
The contraindications for tPA include.
What are severe head trauma within 3 months, previous ICH, suspected SAH, brain or spine surgery within 3 months, SBP>185, DBP> 110, bleeding diathesis, INR >1.7, Heparin/ LMWH/factor Xa inhibitor within 48 hours, thrombocytopenia, CT + hemorrhage, >4.5hrs since last known normal?