NIH Stroke Scale 3

NIH Stroke Scale 3 rate what they actually do - CORRECT ANSWERStips for scoring - CORRECT ANSWERS-use patient's first response - ataxia - CORRECT ANSWERS-lack of muscle coordination, reflects the affected coordination of one who has experienced a stroke Significance of NIH stroke scale - CORRECT ANSWERS-necessary prognostic tool for discerning deficits within different parts of body. provides in common language to understand nature of stroke and severity amongst interdisciplinary team. is the NIH stroke scale a measure of disability? - CORRECT ANSWERS-no, it is a measuring tool of impairments. Relevance to medical specialties - CORRECT ANSWERS-emergency physicians, neurologists - CORRECT ANSWERS-- administer scale items in their - exact order - avoid coaching patient - accept patient's 1st effort - score only what patient does - be consistent NIH level of consciousness item 1a - CORRECT ANSWERS-0 = alert 1 = not alert; aroused with minor verbal stimulation 2 = not alert; requires strong or painful stimulation 3 = reflex movements only or totally unresponsive *coma* NIH level of consciousness item 1B - CORRECT ANSWERS-based on 2 questions 1) patient's age 2) month 0 = answers both questions correctly 1 = answers one question correctly 2 = answers neither questions correctly NIH level of consciousness item 1C - CORRECT ANSWERS-ask patient to perform 2 tasks 1) close your eyes, now open them 2) make a fist (independent limbs) NIH Best Gaze - CORRECT ANSWERS-tests voluntary horizontal eye movements. - notice position of the eyes at rest, - move finger/object horizontally and ask patient to follow moving target 0 = score if acts performed correctly 1 = partial gaze palsy 2 = forced deviation *consider if eye movements are normal* NIH Visual field test - CORRECT ANSWERS-eyes are tested independently patient must be looking directly at your eyes for peripheral tests. 1) cover opposing eye - test peripheral field 0 = no visual loss 1 = partial hemianopia 2 = complete hemianopia 3 = bilateral hemianopia NIH Visual palsy test - CORRECT ANSWERS-1) ask patient to show teeth 2) ask patient to show grimace (discern for symmetry) 3) ask patient to squeeze eyes shut, open them, then raise eye brows 0 = for normal symmetrical movements 1 = minor paralysis or asymmetry when grinning/smiling 3 = complete paralysis NIH Motor ARM - CORRECT ANSWERS-ask for patient to extend limb and maintain limb for 10 sec 0 = no drift 1 = drift 2 = some effort against gravity 3 = no effort against gravity, and arm falls 4 = no movement noted NIH Motor LEG - CORRECT ANSWERS-always test leg in supine position 0 = no drift 1 = drift 2 = some effort against gravity 3 = no effort against gravity 4 = no movement noted NIH Limb Ataxia - CORRECT ANSWERS-ask patient to touch your finger with index finger then back to his nose. with legs, ask patient to place heel of one limb on opposing knee then slide it down and back up to knee 0 = if ataxia present 1 = present in one limb 2 = present in 2 limbs NIH Sensory - CORRECT ANSWERS-0 = normal, no evidence of sensory loss 1 = mild to moderate sensory loss 2 = severe or total sensory loss NIH Best Language - CORRECT ANSWERS-scored based on language skills 0 = no aphasia 1 = no significant limitation, mild to moderate aphasia 2 = NIH Dysarthria - CORRECT ANSWERS-articulation and clarity of speech is tested via verbal expression of words on a note card 0 = normal 1 = mild to moderate slurring 2 = severe slurring NIH extinction / inattention - CORRECT ANSWERS-ask patient to close eyes, ask patient to close eyes, alternatively touch patient's left or right side. ask patient to state which side touched. 0 = 1 = 2 = calculating the scores - CORRE