PrepU Stroke

The DASH diet

*high* in fruits and vegetables *moderate* in low-fat dairy products *low* in animal protein.

t-PA eligibility criteria

Clinical diagnosis of ischemic stroke being 18 years of age or older systolic BP < 185 mm Hg

A nurse practitioner provides health teaching to a patient who has difficulty managing hypertension. This patient is at an increased risk of which type of stroke?

Intracerebral hemorrhage

Contraindications to t-PA.

Intracranial hemorrhage neoplasm aneurysm major surgical procedures within 14 days

The nurse is providing information about strokes to a community group. Which of the following would the nurse identify as the primary initial symptoms of an ischemic stroke?

Weakness on one side of the body and difficulty with speech

Damage to the occipital lobe can result in ________ agnosia,

visual

Hyperglycemia has been associated with poor neurologic outcomes in acute stroke and should be treated if the blood glucose is above _______ mg/dL

140

Severe headache, vomiting, early change in level of consciousness, and seizures are early signs of a ____________ stroke.

hemorrhagic

Which term refers to the inability to perform previously learned purposeful motor acts on a voluntary basis?

Apraxia

Left hemispheric damage causes

aphasia, slow, cautious behavior, and altered intellectual ability.

Damage to the temporal lobe can cause _________ agnosia.

auditory

A patient is in the acute phase of an ischemic stroke. How long does the nurse know that this phase may last?

1 to 3 days

A client diagnosed with a stroke is ordered to receive warfarin. Later, the nurse learns that the warfarin is contraindicated and the order is canceled. The nurse knows that the best alternative medication to give is

ASA

A nurse is caring for a client who has returned to his room after a carotid endarterectomy. Which action should the nurse take first?

Ask the client if he has trouble breathing.

A 76-year-old male client is brought to the clinic by his daughter. The daughter states that her father has had two transient ischemic attacks (TIAs) in the past week. The physician orders carotid angiography, and the report reveals that the carotid artery has been narrowed by atherosclerotic plaques. What treatment option does the nurse expect the physician to offer this client to increase blood flow to the brain?

Balloon angioplasty of the carotid artery followed by stent placement Carotid endarterectomy

_____________ deficits associated with stroke include short- and long-term memory loss, decreased attention span, and poor abstract reasoning.

Cognitive

A client who is at high-risk for a cerebrovascular accident has medication ordered to lower their cholesterol and to prophylactically anticoagulate them. What specific agent might be diagnosed for this client?

Daily aspirin

A family member comes to the clinic to talk to the nurse about a client who has had a stroke on the right side of the brain. The family member is concerned because of the deficits the client is exhibiting. The nurse knows that when a client experiences a stroke on the right side of the brain, common deficits include what?

Left-sided hemiplegia Tendency to distractibility Neglect of objects and people on the left side

What is the initial diagnostic in suspected stroke?

Noncontrast computed tomography (CT)

_______ _________ of people who experience a TIA subsequently develop a stroke.

One third

The nurse is caring for a patient having a hemorrhagic stroke. What position in the bed will the nurse maintain this patient?

Semi-fowlers

While providing information to a community group, the nurse tells them the primary initial symptoms of a hemorrhagic stroke are:

Severe headache and early change in level of consciousness

A client reports light-headedness, speech disturbance, and left-sided weakness lasting for several hours. The neurologist diagnosed a transient ischemic attack, which caused the client great concern. What would the nurse include during client education?

When symptoms cease, the client will return to presymptomatic state.

If warfarin is contraindicated, _________ is the best option, although other medications may be used if both are contraindicated.

aspirin

Dysarthria is

difficulty in forming words.

Dysphagia is

difficulty swallowing.

Diplopia is

double vision.

A complication of a carotid _____________________ is an incisional hematoma, which could compress the trachea causing breathing difficulty for the client.

endarterectomy

If damage has occurred to the ____________ lobe, learning capacity, memory, or other higher cortical intellectual functions may be impaired. Such dysfunction may be reflected in a limited attention span, difficulties in comprehension, forgetfulness, and lack of motivation.

frontal

Which is the most common motor dysfunction seen in clients diagnosed with stroke?

hemiplegia

Cerebral hemorrhage, arteriovenous malformation, cerebral hemorrhage, cerebral aneurysm, arteriovenous malformations, and ruptured cerebral arteries can lead to _______________ stroke.

hemorrhagic

The main presenting symptoms for _____________ stroke are numbness or weakness of the face, arm, or leg, especially on one side of the body, confusion or change in mental status, and trouble speaking or understanding speech.

ischemic

The primary symptoms of a client who experiences a right-sided stroke are

left-sided weakness impulsiveness poor judgment.

Damage to __________ ___________ may cause hemiparesis, hemiplegia, and a change in reflexes.

motor neurons

Clients with right hemispheric stroke exhibit

partial perceptual deficits, left visual field deficit, and paralysis with weakness on the left side of the body

Left-sided hemiplegia (stroke on right side of brain) may have the following neurologic deficits:

spatial-perceptual defects; disregard for the deficits of the affected side require special safety considerations; tendency to distractibility; impulsive behavior, unaware of deficits; poor judgment; defects in left visual fields; misjudge distances; difficulty distinguishing upside-down and right-side up; impairment of short-term memory; neglect left side of body, objects and people on left side.

Perseveration is

the continued and automatic repetition of an activity or word or phrase that is no longer appropriate.

Receptive aphasia is

the inability to comprehend the spoken word.

About 80% of hemorrhagic strokes are intracerebral, and they are caused primarily by ______________ ____________________.

uncontrolled hypertension