Med-Surg Exam 1 Study Guide | Stroke & Cerebrovascular Accident (CVA) | Updated 2025/2026

Med-Surg Exam 1: Stroke & i i i i i




Cerebrovascular Accident (CVA) Study Guide | i i i i i i




Updated 2025/2026 i i




•Causes Neurologic changes, secondary to interruption in the blood supply to a
i i i i i i i i i i i i




part of the brain i i i i i




oMotor Ex: Spasticity in affected limbs
i i i i i i i i i




oSensory Ex: double vision oCognitive Ex: i i i i i i i i




dementia i




•One of leading causes of adult disability
i i i i i i i




•Common diagnosis in Long Term Care (LTC) i i i i i i i




•Significant morbidity in those that survive i i i i i i




•5th most common cause of death in the United States
i i i i i i i i i i




•Leading cause of serious, long-term disability oAbout i i i i i i i i i




800,000 people have a stroke each year i i i i i i i i i i




▪15%-30% with permanent disability i i i i




i i ▪Lifelong change for survivor and family
i i i i i i i




Stroke Risk Factors i i i




•Nonreversible i i




oFamily history i i i




oHeredity oAge i i i


i




o Gender (Ex: Males (more affected by strokes), more mortality in
i i i i i i i i i i i i females) i i




oEthnic background i i




i i i ▪Ex: African American i i i




•Reversible oSubstance abuse oHypertension i i i i i i




(HTN) oHeart disease oSmoking oSleep apnea
i i i i i i i i i i




oMetabolic syndrome oLack of physical i i i i i i




exercise/ poor weight control i i i i i




oPoor diet oLimiting alcohol i i i i i




consumption oBP i i i




management oRoutine health i i i i




assessments i i

,oWomen who experience migraines with an aura are more at risk for strokes
i i i i i i i i i i i i i i i




oindividuals with atrial fib (normal PQRST) are more prone to stroke
i i i i i i i i i i i i

, ▪In some cases of AFib, the fibrillation of the atria causes
i the i i i i i i i i i i i i




ventricles, or lower chambers of the heart, to beat too fast. This is i i i i i i i i i i i i i i




called a rapid ventricular rate or response (RVR). If you have AFib
i i i i i i i i i i i i i




with RVR you'll experience symptoms, typically dizziness and
i i i i i i i i i i




possibly syncope i i




▪Most likely to cause an embolic stroke because the fast
i Heart i i i i i i i i i i i




rate may cause a piece of plaque to breakoff and dislodge within the
i i i i i i i i i i i i i i




artery i




i i •Patients are given Beta blockers and calcium channel i i i i i i i i i i




i blockers to slow the heart rate i i i i i i




***CHADS2 and CHA2DS2-VASc Score for Stroke Risk Assessment in Atrial
i i i i i i i i i i




Fibrillation i




•Most likely be put on anticoagulants, if score is high oBirth
i i i i i i i i i i i




control (predisposes to clots) i i i i




oObesity oDiabetes
i i i i




Primary prevention of Stroke: concerned with preventing the onset of disease.
i i i i i i i i i i i




•Patients are placed on Coumadin oSide i i i i i i i




effects of coumadin: bleeding!!!
i i i i




i i i ▪INR 2-3 range= Therapeutic range i i i i i




i i i ▪INR 4-5 range= Supra-therapeutic i i i i




i i i i •must give vitamin K to reverse the effects i i i i i i i i




•Eliquis=new collection of anticoagulants oCon: i i i i i i i




expensive and some insurance does NOT cover i i i i i i i i




oPro: people can eat as much green foods (vitamin K) as they would like
i i i i i i i i i i i i i i i




•Aspirin (MOST COMMON) i i i




•Dipyridamole (Persantine) i i




•Ticlopidine (Ticlid) i i




•Clopidogrel (Plavix) i i




•Heart valve replacements= you must be put on coumadin
i i i i i i i i i




Secondary prevention: refers to the treatment of individuals who have already had a
i i i i i i i i i i i i i




stroke or transient ischemic attack.
i i i i i

, •Duel Antiplatelet Therapy (DAPT)
i i i i




Interprofessional Care for Stroke
i i i i