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Exam (elaborations)

NIH Stroke Scale Training and Certification

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NIH Stroke Scale Training and Certification rate what they actually do - correct answer tips for scoring - correct answer use patient's first response - ataxia - correct answer lack of muscle coordination, reflects the affected coordination of one who has experienced a stroke Significance of NIH stroke scale - correct answer 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 answer no, it is a measuring tool of impairments. Relevance to medical specialties - correct answer emergency physicians, neurologists - correct answer - 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 answer 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 answer 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 answer ask patient to perform 2 tasks 1) close your eyes, now open them 2) make a fist (independent limbs) NIH Best Gaze - correct answer 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


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