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1538 TEST #3 STUDY SET QUESTIONS AND ANSWERS
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1538 TEST #3 STUDY SET QUESTIONS AND ANSWERS
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1538 TEST #3 STUDY SET QUESTIONSAND ANSWERS
Hemianopia - Answer-blindness in one half of the visual field of one or both eyes
homonymous hemianopsia - Answer-loss of half of the field of view on the same side in
both eyes
Agnosia - Answer-Cannot recognize objects-visual, tactile, or auditory
Apraxia - Answer-And ability to carry out motor pattern dressing, draw a figure
neglect syndrome - Answer-Disorder of attention, cannot integrate/use perceptions from
affected side. Most common in strokes of parietal lobe and right hemisphere.
Pain, numbness, tingling
Right hemisphere stroke: typical signs - Answer-LEFT SIDED WEAKNESS
Impulsive, safety problem, impaired judgment, and time concepts
Left hemi inattention, left visual deficit, left hemiparesis, left hemi-sensory loss
Right gaze preference
Stroke or brain attack - Answer-Gradual or rapid onset of neurological Deficit resulting
from a sudden decrease in blood flow to a localized area of the brain
The two types of strokes are - Answer-ischemic and hemorrhagic
ischemic stroke - Answer-80%, a type of stroke that occurs when the flow of blood to
the brain is blocked, mostly thrombi, can also be embolic
hemorrhagic stroke - Answer-occurs when a blood vessel in the brain leaks or ruptures;
occurs 20%
Primary prevention for stroke - Answer-Awareness and control of modifiable risk factors
People over 65 years old have a greater incidence
Stroke is more common in men than women. women die 65% more the men
African Americans have a greater risk
,Family history plays an important part of the non-modifiable risk factor
What is the number one most important modifiable risk factor for stroke - Answer-HTN
What is the most important treatable cardiac related risk factor for a stroke - Answer-A-
fib or A-flutter
Stroke risk factors - Answer-HTN, HF, DM, Blood cholesterol levels, SMOKING, chronic
AFIB, OBESITY, SEDENTARY LIFESTYLE, substance-abuse, ORAL
CONTRACEPTIVE, PREVIOUS STROKE, pregnancy, childbirth, menopause,
migraines with aura, auto immune disorders, clotting disorders, sleep apnea, sickle cell
disease
When is cerebral blood flow impaired - Answer-When SBP > 160 it causes distention of
cerebral arteries
SBP <50
~ neurologic metabolism is altered and 30 second
~ metabolism stops in 2 minutes
~ Cellular death occurs in 5 minutes
Atherosclerosis - Answer-Hardening and thickening of the arteries and is a major cause
of the stroke
Penumbra - Answer-Is a zone of a reversible ischemia around a core of irreversible
infarction. this area of the brain is salvageable in the first few hours (<3) after onset of
acute ischemic stroke symptoms
Transient Ischemic Attack (TIA) - Answer-Reversible focal dysfunction for minutes to
less than 1 hour, patient may have stroke within a year of this
Stroke Preventative medications after a TIA - Answer-Aspirin, ticlopidine (Tiflid),
clopidogrel (Plavix), dipyridamole (Persantine)
Ischemic strokes (Thrombolic) - Answer-Thrombosis occurs in relation to injury to a
blood vessel wall and formation of a blood clot, result of thrombosis or narrowing of the
blood vessel
Most common cause of a stroke
2/3 are associated with HTN & DM
often preceded by TIA
Assessment of strokes - Answer-Ischemic stroke symptoms may progress in the first 72
hours as infarction and cerebral edema increase.
,Assessment of level of consciousness, pupillary size, and reactivity; and respiratory
pattern should be done frequently to identify any changes in the patient's status
What does the medulla do? - Answer-controls breathing pattern *critical to monitor*
Ischemic stroke: Embolic - Answer-Most common cause is A-fib, patient with embolic
stroke commonly have a rapid occurrence of severe clinical symptoms
hemorrhagic stroke - Answer-Most fatal.
Results from bleeding into the brain tissue itself or into the subarachnoid space or
ventricles
Hemorrhagic stroke: intracerebral hemorrhage - Answer-HTN is the most common
cause and most often in the elderly.
Trauma and drug use (cocían or amphetamines) are usually the cause when seen in a
young adult.
The increase blood mass causes pressure on brain tissue, displaces the brain tissue
and decreases cerebral blood flow leading to ischemia and infarction
Diagnostic studies for stroke - Answer-CT of the brain WITHOUT contrast is the MOST
IMPORTANT
CT scan is completed and read with in 45 minutes of the patient arrival to the ED
Symptoms suggestive of a hemorrhage - Answer-Headache, nausea, vomiting,
decreased LOC (not always present), intolerance to light, neck stiffness/pain
If a patient comes in and they do not know when the symptoms started are they eligible
for anti-thrombolic therapy? - Answer-No, it must be within 3 hours
Left hemispheric stroke is more likely to cause what In most people - Answer-Aphasia
Dysarthria - Answer-disturbance in muscular control of speech.
It does not affect the meaning of communication or the comprehension of language
aphasia - Answer-impairment of language, usually caused by left hemisphere damage
either to Broca's area (impairing speaking) or to Wernicke's area (impairing
understanding).
dysphasia - Answer-difficulty speaking
Prevention of stroke: Health Promotion - Answer-Stop smoking,
, limit ETOH intake,
HEALTHY DIET: LOW IN SATURATED FAT, TOTAL FAT, CHOLESTEROL AND
SODIUM. HIGH IN FRUITS AND VEGETABLES
normal blood pressure,
weight control,
regular exercise,
routine health examination
Secondary prevention: Screening - Answer-DM
HTN
Obesity
High Serum lipids
Cardiac Dysfunction
Nonpharmacological methods for cholesterol reduction - Answer-Reduce total fat intake
to 30% or less of caloric intake.
Reduce cholesterol intake to 300 mg per day or less
Exercise as possible
Stop smoking
Statins - Answer-lower cholesterol in the blood and reduce its production in the liver by
blocking the enzyme that produces it
Atorvastatin (Lipitor)
Fluvastatin (Lesvol)
Lovastatin (Mevacor)
Pravastatin (Pravachol)
Rosuvastatin (Crestor)
Simvastatin (Zocor)
Statins: side effects and adverse effects - Answer-Headache,
G.I. disturbance, and dizziness,
liver impairment,
rhabdomyolysis (skeletal muscle disorder)
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