Strokes and Related Nursing Care Qs&As 2024

Strokes and Related Nursing Care Qs&As 2024 Cerebrovascular Accident - ANS-Emergency Condition that causes neurological deficits from a decreased blood supply to a local area of the brain. CVAs are the 4th leading cause of death in the US. Strokes can occur at any age, the highest incidence is in people over 65 of ages. Risk factors include: African Americans, diabetes, hypertension, obesity, atrial fibrillation, sleep apnea, physical inactivity and atherosclerosis. Smoking, high cholesterol intake, excessive use of alcohol and cocaine/heroin use increase the risk. Transient Ischemic Attack - ANS-Brief episode of reversible neurological deficits, lasts from few minutes to less than 24 hours. It results from temporary reduction of blood flow to a specific area of the brain. Usually caused by atherosclerosis, or a small embolus, which obstructs a small cerebral blood vessel. TIAs are often warning signs before CVAs. Time between the two ranges from hours to months. Manifestations include: dizziness, visual loss in one eye, contrlateral numbness or weakess of the fingers, arms, or legs, aphasia. CVAs - ANS-Sudden loss of neurologic function. Two types: Ischemic -from a thrombus or embolus. Hemorrhagic -intracerebral hemorrhage or subarachnoid hemorrhage. Anyone of these partially or completely reduce blood flow to cerebral tissues. This decreases oxygen to the area of the brain supplied by the involved blood vessels. Initially the brain cells are ischemic, but quickly die, resulting in a cerebral infraction. If the brain experiences anoxia (lack of O2 to the brain), for more than 10 minutes, irreversible brain damage occurs. Maintaining survival of these cells depends on a timely return of adequate circulation. Thrombolytic Agents -Recombinant Tissue Plasminogen Activator tPA - ANS-Used early in the treatment of ischemic stroke to preserve the penumbra. Adequate collateral blood supply can decrease the amount of damage. tPA -re-establish blood flow through blocked artery to prevent cell death in clients with acute onset of ischemic stroke symptoms. Cannot be used for hemmorhagic stroke. Given within 3 hours of onset of symptoms: decreases disability, but at the expense of increase in deaths within the first 7-10 days and increase intracranial hemorrhage. Be Fast - ANS-Balance Emotion/eyes Face Arm Speech Time Right sided CVA - ANS-Left hemiplegia Left visual field deficits Spatial-perceptual deficits Denies or unaware of deficits Easily distracted Poor judgement Impulsive Left Sided CVA - ANS-Right hemiplegia Right visual field deficits Aphasia Aware of deficits Impaired intellectual ability Slow, cautious behavior High level of frustration over losses Aphasia (Speech Deficits) - ANS-Usually result from a CVA affecting the dominant hemisphere. The left hemisphere is dominant in all right-handed people and most left-handed people. Expressive aphasia -an ability to speak/wright due to damage of the Broca area. Pt can understand what is being said