RNSG 2432, Exam 3: Module 9 – CVA|Advanced Neurovascular Nursing Examination: Cerebral Blood Flow Autoregulation, Internal Carotid and Vertebral Artery Circulation, Transient Ischemic Attack Risk Stratification and ABCD Scoring, Ischemic Stroke Thrombotic

RNSG 2432, Exam 3: Module 9 – CVA|Advanced Neurovascular Nursing Examination: Cerebral Blood Flow Autoregulation, Internal Carotid and Vertebral Artery Circulation, Transient Ischemic Attack Risk Stratification and ABCD Scoring, Ischemic Stroke Thrombotic and Embolic Pathophysiology, Hemorrhagic Stroke Intracerebral and Subarachnoid Hemorrhage, Cerebral Perfusion Pressure and Mean Arterial Pressure Regulation, FAST and BE FAST Stroke Recognition Protocols, National Institutes of Health Stroke Scale Assessment, Non-Contrast CT Emergency Stroke Diagnostics, Recombinant Tissue Plasminogen Activator Thrombolytic Therapy and Contraindications, Endovascular Mechanical Thrombectomy Intervention, Cerebral Edema and Increased Intracranial Pressure Management, Dysphagia Screening and Aspiration Prevention Exam Questions Verified and Provided with Complete A+ Graded Rationales Latest Updated 2026 Cerebral Blood Flow •How is the brain supplied with oxygen and nutrients? Internal carotid arteries vertebral arteries What areas do they each supply with blood? carotids—Frontal Parietal and temporal lobes, basal ganglia, diencephalon (thalamus and hypothalamus) Vertebral Arteries = Middle and lower parts of the temporal lobes, occipital lobes cerebellum brainstem and part of the diencephalon. Prevention is KEY - CVA modifiable risk factors Hypertension SINGLE MOST important modifiable Risk Heart disease SMOKING Obesity Sleep apnea Poor diet Drug use Alcohol CVA non-modifiable risk factors •Age 60 or •Gender male •Ethnicity - blacks highest rate •Family history •Hereditary •Increased with age and DOUBLES each decade after 55. The Boss = The Brain •The brain is selfish and requires a constant and continuous supply of oxygen and glucose to function •Blood flow must be maintained at 750-1000 ml/min or about 20% of the total cardiac output. •What factors can affect the blood flow to the brain? •BP, CO, blood viscosity, ICP? if MAP = 50-150, the brain can autoregulate MAP calculation formula MAP = (SBP + 2DBP)/3 what is a TIA •Transient ischemic attack •Risk factor for strokes •Signs and symptoms depend on the effected vessel • Carotid •Vertebrobasilar TIA •Transient episode of neurologic dysfunction without acute infarction of brain •Symptoms typically last 1 hr or less •Warning sign for stroke (CVA) •1/3 will have additional TIA’s •1/3 of TIA’s will progress to stroke •ABCD score tool is used to predict risk of stroke after a TIA. ABCD score for TIA ranks risk for stroke Score 1-3 - outpt. tx 4-5 hospitalize 6-7 hospitalize A= age B= BP C= clinical presentation D= duration What is a stroke •Tissue in the brain that is deprived of oxygen and nutrients. Anything more than 5 minutes can cause damage. •Stroke Classifications Ischemic Hemorrhagic Ischemic Stroke •Thrombotic •Occurs from injury to a blood vessel wall and formation of a blood clot. •More common in older adults especially those with high cholesterol atherosclerosis or diabetes, Most are associated with HTN and or diabetes. •Embolic •Occurs when and embolus lodges in and occludes cerebral artery (2nd most common cause of cva) usually from endocarditis or A-Fib Hemorrhagic These result from bleeding into the brain tissue itself. Intracerebral =Bleeding in the brain that is caused by rupture of a vessel Subarachnoid =Bleeding between the arachnoid and the pia mater Clinical manifestations •Motor Function •Communication •Affect •Intellectual Function •Spatial perceptual problems •Elimination issues CVA - What to DO •Act FAST!! Time is brain •Recognize what is happening *F = facial drooping *A = arm drift *S = slurred speech *T = time of last known wellness •CT Non Contrast (or MRI Per Book), Blood glucose, Neuro assessment to include NIHSS NIHSS