TYPES OF STROKES
SIGNS AND SYMPTOMS
TESTS AND PROCEDURES
CNS SCALE
NURSING CARE
100
The most common type of stroke.
What is ischemic?
100
Sudden numbness or weakness of face, arm, or leg, especially on one side of body.
What are some of the common symptoms of stroke?
100
A commonly ordered test to determine if a stroke has occurred and what kind of stroke.
What is a CT scan?
100
11.5
What is the maximum score?
100
37.5
What is the body temperature when you should start treatment for hyperthermia?
200
Anticoagulants and thrombotics increase the risk of this type of stroke.
What is intracerebral hemorrhagic stroke?
200
Numbness, trouble speaking, loss of balance or coordination which resolve in <24 hours.
What are common symptoms of TIA?
200
A commonly ordered test that gives very accurate images that show the presence, location, and size of aneurysms as well as the vessels of the brain.
What is an MRI?
200
Decrease of more than 1 point from previous CNS score.
When to notify the physician?
200
The process of moving in bed, sitting up, standing and eventually walking.
What is mobilization?
300
The type of ischemic stroke caused by a clot or plaque fragment the travels through the bloodstream to the brain.
What is embolic?
300
Sudden confusion, trouble speaking, or understanding; sudden severe headache with no known cause.
What are some common symptoms of stroke?
300
Commonly ordered tests using IV radioactive compounds.
What are CTA and MRA?
300
Patient is unable to understand both spoken and written words?
What is a receptive speech deficit?
300
<92%
When should you apply oxygen to a patient with stroke?
400
The most common cause of intracerebral hemorrhagic stroke.
What is hypertension?
400
Sudden nausea and vomiting; brief loss of consciousness or a period of decreased consciousness (fainting, confusion, convulsions or coma).
What are some of the symptoms of hemorragic stroke?
400
This clot-busting drug must be given within 4.5 hours or onset of stroke symptoms.
What is tPA?
400
slurred speech.
What is Dysarthria?
400
The area of viable tissue (dysfunctional area) adjacent to the area of infarction.
What is the ischemic penumba?
500
Hypertension, smoking, diabetes, atrial fibrillation, sleep apnea, dyslipidemia, excessive alcohol, carotid disease
What are modifiable stroke risk factors?
500
A visual field loss on the same side of both eyes.
What is homonymous hemianopia?
500
The device is threaded through the arteries into the brain to retrieve a clot.
What is endovascular clot retrieval?
500
Posterior circulation symptoms and strokes
What is not covered in the CNSS assessment?
500
VTE prophylaxis for acute hemorrhagic stroke
What are TEDS and SCDs?
M
e
n
u