N4 Test - Different Strokes for Different Folks

I got stoke info from this article and reduced it:

Are you ready to manage patients with acute ischemic stroke?
http://www.nursingcenter.com/prodev/ce_article.asp?tid=592119

Hemorrhagic stroke - 20% - BV in brain ruptures - blood seeps into brain

Ischemic stroke – 80% - Thrombotic or Embolic

Thrombotic – 70% - plaque buildup in arteries – plaque ruptures – clot forms at site (thrombus) – occludes lumen of artery – leading cause atherosclerosis – S/Sx – over time (hours or days)

Embolic – 30% - traveling blood clot (embolus) – occludes artery in brain – leading cause A-fib – S/Sx – acute then resolving

Both – Symptoms depend on degree of blockage and location in brain.

TIAs may or may not be in history.

TIA - (same S/Sx as stroke but resolve in less than 24 h)

Brain - Two blood systems - carotid and vertebral

carotid system – face – 60% of cerebrum

S/Sx of occlusion - varying degrees

* sudden onset of sensory deficits on one-side of the body

* hemiparesis (weakness or partial one-sided paralysis)

* hemiplegia (one-sided paralysis)

* one-sided monocular vision loss

* aphasia (inability to speak or to understand what others are saying)

* dysarthria (a speech disorder involving the muscles used to speak; words are slurred, difficult to form)

* confusion.

Vertebral system - brainstem, cerebellum, and the posterior region of the cerebrum S/Sx of occlusion

* dizziness

* lack of coordination

* clumsiness

* blindness

* paralysis

* coma.

Other signs and symptoms of stroke include a sudden and severe headache, visual disturbances, and difficulty walking.

Go to this article to read up on the timeline management of diff strokes
TEST

1.	Stroke is the leading cause of
	a. long-term disability in adults.
	b. diabetes.
	c. hypertension.
	d. glaucoma.
2.	Which person is at the highest risk of having a stroke?
	a. a 50-year-old woman with hypothyroidism
	b. a 65-year-old man with hypertension
	c. a 70-year-old woman with heart failure
	d. a 75-year-old woman with atrial fibrillation and hypertension
3.	Thrombotic strokes are caused by
	a. an embolism from the legs.
	b. hypotension and hypoglycemia.
	c. progression of atherosclerotic disease.
	d. a massive bleed into the brain tissue.
4.	Which statement about transient ischemic attacks is true?
	a. They occur when a cerebral vessel dilates rapidly.
	b. They result from a massive bleed into the brain tissue.
	c. Symptoms resolve within 24 hours.
	d. They aren't usually a sign of impending stroke.
5.	Patients with an occlusion of the vertebral arterial system will exhibit
	a. hemiparesis.
	b. aphasia.
	c. blindness.
	d. dysarthria.
6.	Patients suspected of having a stroke should have which diagnostic study within 25 minutes of arriving to the hospital?
	a. electrocardiogram
	b. computed tomography scan of the head
	c. chest X-ray
	d. cerebral angiogram
7.	Patients with an occlusion of the carotid system will exhibit
	a. hemiparesis.
	b. dizziness.
	c. blindness.
	d. increased visual acuity.
8.	To be eligible for thrombolytics, the patient must
	a. not have eaten anything for 8 hours.
	b. arrive at the emergency department within 3 hours of stroke symptoms.
	c. have a blood pressure of 220/120 mm Hg.
	d. have a blood glucose level of 425 mg/dl.
9.	The only Food and Drug Administration-approved thrombolytic approved for stroke is
	a. unfractionated heparin.
	b. low-molecular weight heparin.
	c. warfarin.
	d. tissue plasminogen activator.
10.	The American Diabetes Association recommends keeping a stroke patient's blood glucose level
	a. between 200 and 220 mg/dl.
	b. as close to 110 mg/dl as possible, and less than 180 mg/dl.
	c. above 400 mg/dl.
	d. between 180 and 200 mg/dl.
11.	An antiplatelet agent commonly used in stroke patients is
	a. acetaminophen.
	b. aspirin.
	c. digoxin.
	d. furosemide.
12.	One of the most frequent causes of death within the first month of a stroke is
	a. hypothyroidism.
	b. a TIA.
	c. falls.
	d. pneumonia.
13.	To prevent deep vein thrombosis, you should
	a. perform frequent neurologic checks.
	b. apply pneumatic compression devices to patients who aren't ambulatory.
	c. keep the head of the bed elevated at 45 degrees.
	d. keep the patient in bed for 3 days.
14.	To reduce the risk of pneumonia in a stroke patient who has trouble swallowing,
	a. keep the patient supine.
	b. elevate the head of the bed 20 degrees when feeding the patient.
	c. avoid performing mouth care.
	d. keep the patient N.P.O. until seen by a speech therapist.
15.	A patient who has dysarthria will have
	a. one-sided paralysis.
	b. one-sided weakness.
	c. difficulty swallowing.
	d. slurring of words.