Final Exam Content Guide
1. Stroke – CVA – Brain attack disruption of cerebral blood flow secondary to ischemia, hemorrhage, brain attack, or embolism
1) Hemorrhagic – ruptured artery or aneurysm = ischemia and ↑ICP ca
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Final Exam Content Guide
1. Stroke – CVA – Brain attack disruption of cerebral blood flow secondary to ischemia, hemorrhage, brain attack, or embolism
1) Hemorrhagic – ruptured artery or aneurysm = ischemia and ↑ICP caused by expanding collection of blood. Prognosis poor.
2) Thrombotic – d/t development of blood clot on an atherosclerotic plaque in a cerebral artery. The clot gradually shuts off the artery causing ischemia distal to the occlusion. Symptoms evolve over several hours to days.
3) Embolic – d/t embolus traveling from another part of the body to the cerebral artery. Blood to brain
distal to occlusion immediately shuts off causing neuro deficits, or a loss of consciousness can instantly occur. --- This type of stroke may be reversed with rtPA if given within 4.5hrs of initial symptoms.
Risk Factors: HTN, DM, smoking == PREVENTION == Early treatment of HTN, maintain BGL, quit smoking. Right vs Left: Right = visual and spatial awareness and propriception. Left = language, math, and analytic thinking (agnosia – inability to recognize familiar objects).
Interventions: Have suction equipment avail. Vitals 1-2hrs – Notify MD if BP >180/110. Temp (↑ can cause ↑ICP). O2 and maintain > 92%. Cardiac monitor. Monitor LOC (↑ICP). Elevate HOB >30 to reduce ICP and promote venous drainage. Maintain midline neutral position. SEIZURE Percautions. Assist with communication. Assist with safe feeding. Intervene for complications r/t immobility. Active ROM to unaffected exteemities, and Passive ROM to affected extremities. Vision deficits = instruct scanning techinique (turning head). Prevent DVT. Assist with ADL’s. Provide frequent rest.
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