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CVA & ICP Exam 6 Questions And 100% Correct Answers
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CVA & ICP Exam 6 Questions And 100%Correct Answers
when would you call an RRT? - ANSWER if pt has symptoms of a stroke
"being concerned about a patient"
"gut feeling"
*acute changes:*
--> HR <40 or >130
--> BP <90 and symptomatic
--> resp rate <6 or >30
--> changes in neuro status
--> saturation <90% despite oxygen
--> new/repeated seizure activity
--> new onset of chest pain
what is a CVA - ANSWER stroke
interruption of O2 and glucose delivery to brain cells
cellular death occurs in _______ mins if blood flow is interrupted - ANSWER 5 mins
cerebral autoregulation - ANSWER changes the diameter of blood vessels in order to
maintain constant blood flow to the brain when changes in BP occur
*when autoregulation is damaged (stroke) cerebral blood flow is dependant on BP*
BP, CO, & blood viscosity affect __________ - ANSWER blood flow
,If one carotid artery is obstructed what will occur? - ANS circle of willis will supply that
side of brain from the other carotid artery
non modifiable vs modifiable risk factors for a stroke - ANS *nonmodifiable:*
--> age
--> gender
--> race (blacks @ higher risk)
--> family hx
*modifiable:*
--> HTN
--> heart disease
--> Afib
--> smoking
--> alcohol consumption
--> obesity
--> sleep apnea (leads to Afib & stroke)
--> metabolic syndrome high BP, gluc, triglycerides, low HDL, central obesity
--> sedentary life style
--> drug abuse
--> diabetes
--> high cholesterol
--> sickle cell anemia
BEFAST stroke scale - ANSWER B = balance sudden loss of balance
E = eyes vision in 1 or both eyes
F = face face uneven?
A = arms 1 arm weak or numb?
,S = speech slurred having trouble speaking
T = time call 911
ischemic stroke
3 types - ANSWER a clot partially or completely blocks blood flow to an area of the brain
1. *thrombotic* (most common)
--> blood clot forms b/c atherosclerosis-plaque rupture (plaque shifts and PLTs rush to
site)
2. *TIA*
--> small thrombotic stroke w/o infarction
--> temporary neuro dysfunction
--> 1/3 of pts w/ symptoms will progress to stroke
--> happens slowly (many times s/s occur during or after sleep)
3. *embolic*
-->
thrombus formation somewhere else (afib, MI, valve prosthesis, long bone fracture)
migrates to brain
*strokes can occur early morning- possibly related to blood viscosity and platelet
aggregation, which have been found to increase following sleep and early morning
*can be related to the renin-angiotension-aldosterone system. Some studies say it has
less to do with the circadian rhythm of humans and more to do with the stress of
mornings.
CT Scan: Ischemic Stroke - ANSWER Ischemic areas may not initially be visible on the
CT Scan until 48 hours later.
As the cells die from lack of blood flow the effected area highlights.
, hemorrhagic stroke
2 types - ANSWER 1. *intracerebral hemorrhage*
--> rupture of blood vessel in brain
--> prognosis is poorest
*causes:*
--> HTN = most common
--> anticoagulants
--> trauma
--> tumors
--> ruptured aneurysms
2. *subarachnoid hemorrhage*
--> bleeding into the spinal fluid filled space around brain
--> most caused by ruptured aneurysms-poor prognosis
--> patients state "worst headache ever in my life"
--> most occur in the Circle of Willis
CT Scan: Hemorrhagic Stroke - ANSWER hemorrhage can be seen immediately on the
CT Scan
Diagnostic Tests For Stroke - ANSWER 1. *CT scan*
--> quickest - able to determine quickly if thrombolytic is indicated
--> will show hemorrhage or tumors
--> *CTA*- inject dye IV to visualize blood flow
2. *MRI*
--> better for determining ischemic areas
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