- Shuffle
Toggle OnToggle Off
- Alphabetize
Toggle OnToggle Off
- Front First
Toggle OnToggle Off
- Both Sides
Toggle OnToggle Off
Front
How to study your flashcards.
Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key
Up/Down arrow keys: Flip the card between the front and back.down keyup key
H key: Show hint (3rd side).h key
PLAY BUTTON
PLAY BUTTON
118 Cards in this Set
- Front
- Back
|
What does complete recovery of stroke depend on?
|
circulation returning to normal
|
|
This is often a warning sign of a stroke.
|
transient ischemic attack
|
|
What is the most common cause of stroke?
|
thrombosis due to atherosclerosis
|
|
Who is most at risk for embolus?
|
individuals with a-fib, orthopedic surgery
|
|
What is the most important modifiable risk factor for stroke?
|
hypertension
|
|
Obesity is defined as BMI > ___.
|
30
|
|
What are non-modifiable risk factors for stroke?
|
age, gender, race
|
|
What is dysphagia?
|
impaired swallowing
|
|
What is agraphia?
|
loss of ability to write
|
|
_____ aphasia is difficulty making thoughts known to others.
|
Expressive
|
|
____ aphasia is difficulty understanding what others tries to communicate.
|
Receptive
|
|
What is dysarthria?
|
paralysis of the facial muscles
|
|
What does the affected side of vision correspond with?
|
paralyzed side of body
|
|
What is homonymous hemianopia?
|
loss of half of visual field
|
|
What is proprioception?
|
awareness of body position on space
|
|
What does the extent of injury with a stroke depend on?
|
artery location
|
|
What type of medical intervention is needed for stroke if A-fib is present?
|
anticoagulant therapy
|
|
This treatment dramatically improves the chance of survival?
|
rtPA--> recombinant tissue plasminogen activator
|
|
How soon should rtPA be administered?
|
within the 3 hours of s/s
|
|
What is rtPA contraindicated in?
|
active or history of bleeding, low platelet count, taking anticoagulants
|
|
What is there a huge risk for if gag reflex is decreased?
|
aspiration
|
|
____ therapy will help evaluate the pts ability to eat safely
|
Speech
|
|
What type of foods are tolerated best for stroke patients?
|
semi-solid
|
|
What position should stroke patient be in for meals?
|
High-Fowler's
|
|
How long should stroke patient stay in High-Fowler's after eating?
|
45-60 minutes
|
|
For homonymous hemianopia, where should personal belongings be placed?
|
on unaffected side
|
|
How do you prevent edema in the lower extremities?
|
elevation of limbs
|
|
When should rehab begin?
|
day 1
|
|
What should the patient do as much of as possible, even though it can be time consuming?
|
self-care
|
|
What is a bowel complication associated with stroke?
|
fecal impaction
|
|
This affects the legs more often than the arms.
|
peripheral vascular disease
|
|
What is the patho of PVD?
|
occluded arterial blood flow due to atherosclerosis
|
|
What is the most common s/s of PVD?
|
intermittent claudication; may have numbness in leg muscles
|
|
What is the skin appearance with PVD?
|
skin may be smooth and shinny with hair loss
|
|
PVD decreases ___ ____.
|
peripheral pulses
|
|
What is a major predisposing factor for PVD?
|
hypertension
|
|
This identifies the severity of occlusive disease.
|
Ankle Brachial Pressure Index
|
|
What is a major intervention for treating PVD?
|
legs should be kept level with the heart; wear well fitted shoes
|
|
What should be checked distal to occlusion in PVD?
|
pulses
|
|
These have been reported to decrease progression of atherosclerosis in pts with peripheral arterial occlusive disease.
|
antiplatelet agents (ASA)
|
|
What is Raynaud's disease?
|
vasospasms of digital arteries
|
|
What might individuals with Raynaud's later develop?
|
connective tissue disease
|
|
What does Raynaud's usually affect?
|
hand
|
|
What is the treatment for Raynaud's?
|
abstention from tobacco; cover extremities involved when exposed to cold
|
|
What is deep vein thrombophlebitis?
|
inflammation of a vein that has formed a clot
|
|
What forms a clot in DVT?
|
platelets, RBC, fibrin
|
|
What are the three factors that contribute to the development of DVT?
|
stasis, vascular damage, and hypercoagulability
|
|
What are the causes of venous stasis?
|
A-fib, orthopedic surgery, prolonged immobility
|
|
What are the causes of hypercoagulability of blood?
|
cigarette smoking, pregnancy
|
|
What are the s/s that occur with DVT that only happen when the clot completely obstructs blood flow?
|
swelling, muscle tenderness, warmth of the affected extremity, pain, malaise, fever
|
|
What is the most common symptom with DVT?
|
pain
|
|
How is post-thrombotic syndrome characterized?
|
skin changes (ankle reddish-brown discoloration), ulceration (stasis ulcer)
|
|
What are some of the diagnostics for DVT?
|
venous ultrasonography, d-dimer
|
|
This is an unreliable diagnostic for DVT?
|
Homan's sign--> pain during dorsiflexion of the foot
|
|
What is the most important reason for treating DVT?
|
prevention of PE
|
|
What is the cornerstone for DVT therapy?
|
Heparin, Lovenox, and Coumadin
|
|
Why is lab monitoring easier with Lovenox therapy?
|
longer half-life
|
|
With lovenox injections what might the patient notice?
|
small, purple hemorrhage area on the upper abdomen
|
|
What is important to overlap heparin treatment with?
|
Coumadin
|
|
Coumadin blocks ____ ____.
|
prothrombin synthesis
|
|
What does Coumadin interfere with?
|
Vitamin K
|
|
How often should INR be checked for patients on Coumadin?
|
q 4-6 weeks
|
|
How should the involved extremity be positioned to avoid edema?
|
above the heart to increase venous return
|
|
What should you avoid doing to keep the clot from moving?
|
rubbing the leg or ambulating the client
|
|
Which labs should be monitored if taking Lovenox?
|
CBC and platelet
|
|
What is the antidote for Heparin and Lovenox?
|
Protamine Sulfate
|
|
What is the antidote for Coumadin?
|
Vitamin K
|
|
What should you tell the patient on anticoagulant therapy to avoid regarding OTC drugs?
|
aspirin; obtain physician's permission
|
|
When ambulating what should the client with DVT use?
|
elastic stockings
|
|
What are some preventative measures for DVT?
|
early ambulation in post-op patients, passive or active ROM for bedridden patients, change IV tubing q24-48 hours and IV catheter q48-96 hours, avoid sitting or standing for long time, TED stockings
|
|
What is one of the most common preventable diseases?
|
pulmonary embolism
|
|
What is the cause of a PE?
|
usually when a thrombus in the deep veins of the lower extremities loosens or dislodges and moves to the pulmonary system
|
|
What is a major s/s of PE?
|
pleuritic chest pain
|
|
What type of diet should be ordered for a stroke patient?
|
provide adequate fluid intake; diet with enough roughage for sufficient quantity of bowel content (increase fiber)
|
|
What is PVD?
|
progressive narrowing and degenerative disease of the blood vessels in the peripheral circulation
|
|
What is the leading cause of PVD in pts over 40?
|
atherosclerosis
|
|
What have antiplatelets been reported to do?
|
decrease progression of atherosclerosis in patients with peripheral arterial occlusive disease
|
|
What is the treatment for Raynaud's?
|
abstention from tobacco; cover extremities involved when exposed to cold
|
|
What are some causes of venous stasis?
|
advanced age, A-fib, orthopedic surgery, prolonged immobility
|
|
What are some causes of endothelial damage?
|
trauma, IV medications, abdominal surgery
|
|
What are some causes of hypercoagulability?
|
cigarette smoking, pregnancy, estrogen therapy
|
|
This develops in 40-60% of clients with DVT?
|
post-thrombotic syndrome
|
|
How is post-thrombotic characterized?
|
chronic leg pain, edema, skin changes (ankle reddish-brown discoloration) ulceration
|
|
What does doppler ultrasound measure?
|
velocity of blood flow in veins
|
|
What does D-dimer measure?
|
fibrin degredation fragments
|
|
A patient with DVT should be put on __ ___ so the clot wont embolize.
|
bed rest
|
|
What causes atherosclerosis?
|
HTN, high cholesterol (fatty foods)
|
|
What are the primary causes of stroke?
|
thrombosis, embolus, hemorrhage
|
|
What has been shown to be an independent risk factor for stroke?
|
obesity and abdominal fat
|
|
Why is A-fib a risk factor for stroke?
|
because of venous stasis--> more potential for clotting
|
|
What is the only s/s you will see on the same side as the stroke?
|
dropping eyelid (ptosis)
|
|
If you have a left-sided stroke what are the s/s on the right side?
|
hemianopia and paralysis
|
|
What is a nursing intervention for hemianopsia?
|
teach the patient to scan (turn the head to see things on affected side)
|
|
For a left-sided stroke where might the dysarthia be manifested?
|
on the right side
|
|
What is the diagnostic for stroke?
|
MRI and CT scan
|
|
What are the nursing interventions for acute care patients with stroke?
|
neuro checks, monitor for increased ICP, observe face for symmetry
|
|
What is "arm drift"
|
try to keep your hands up and they drift down
|
|
What is the best way to prevent aspiration?
|
assess for gag reflex (but the presence of a gag reflex is not guarantee against aspiration)
|
|
What type of diet should the patient be on until gag reflex is evaluated?
|
NPO
|
|
How should the nurse approach a client with hemianopsia?
|
on the unaffected side
|
|
WHy should we keep stroke client in prone position for 15 minutes?
|
prevent contractions
|
|
Why do contractures occur?
|
arms have not been moved; no ROM has been performed q4' on all extremities
|
|
What is important for the clients and family members?
|
referrals (family coping strategies)
|
|
What is a major NI for expressive aphasia?
|
associate words with physical objects
|
|
What is very helpful for a patient with receptive aphasia?
|
nonverbal communication
|
|
What disorder is commonly associated with PVD?
|
diabetes
|
|
What type of treatment might be best for PVD?
|
antiplatelets (ASA)
|
|
What is the name of the pain for PVD?
|
intermittent claudication (relieved with rest)
|
|
How should the legs be positioned with PVD?
|
level with the heart
|
|
What should a client avoid wearing with a venous disease (PVD).
|
TED hose
|
|
How should the legs be positioned with DVT?
|
above the heart
|
|
What are some NI for arterial occlusive disease?
|
wash legs with warm water, do not wear ted hose, apply moisturizing cream to feet
|
|
What is rest pain with arterial occlusive disease?
|
his legs are deprived of oxygen during periods of inactivity
|
|
Why is Nifedipine a treatment for Raynaud's?
|
helps with arterial dilation
|
|
What should be monitored on a patient taking Coumadin?
|
intake of vitamin K rich foods (green leafy vegetables)
|
|
What is HIT?
|
an allergy against heparin; develop antibodies against heparin
|
|
What does HIT do to platelets?
|
they are dropped by 50%
|
|
What is the most important NI for prevention of DVT in pre-op patients?
|
in bed ROM
|
