Podcast
Questions and Answers
What is the primary purpose of prescribing Coumadin/Warfarin for a patient with a CVA?
What is the primary purpose of prescribing Coumadin/Warfarin for a patient with a CVA?
Which type of stroke accounts for 87% of all strokes?
Which type of stroke accounts for 87% of all strokes?
In the context of stroke phases, what indicates the transition from the acute phase to the rehab phase?
In the context of stroke phases, what indicates the transition from the acute phase to the rehab phase?
What is a critical nursing consideration immediately after a stroke?
What is a critical nursing consideration immediately after a stroke?
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What is the maximum time frame in which TPA must be administered for it to be effective in stroke treatment?
What is the maximum time frame in which TPA must be administered for it to be effective in stroke treatment?
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Which adverse effect is associated with the administration of beta-adrenergic blockers?
Which adverse effect is associated with the administration of beta-adrenergic blockers?
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Which food is recommended for patients on loop diuretics to help manage potassium levels?
Which food is recommended for patients on loop diuretics to help manage potassium levels?
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What potential side effect should be monitored in patients taking verapamil, a calcium channel blocker?
What potential side effect should be monitored in patients taking verapamil, a calcium channel blocker?
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Study Notes
CVA (Cerebrovascular Accident) - Location and Symptoms
- Left Side Brain Injury Symptoms: Symptoms related to language deficits, comprehension, and speech processing may indicate left side brain injury.
- Right Side Brain Injury Symptoms: Symptoms related to spatial-perceptual issues, lack of recognition, and difficulty with non-verbal communication may indicate right side brain injury.
Transient Ischemic Attack (TIA)
- TIAs are temporary and usually resolve within 24 hours.
- TIAs act as a warning sign for potential full-blown CVAs.
- Key characteristic: Temporary and resolves quickly.
Coumadin/Warfarin in CVA Treatment
- Coumadin/Warfarin is an anticoagulant.
- Rationale for use in CVA is to prevent blood clots.
Types of CVA
-
Ischemic Stroke (87%): Caused by blood clots.
- Embolic Stroke: Blood clots form elsewhere (heart, etc) then travel to and block brain arteries.
- Thrombotic Stroke: Blood clots form directly within brain arteries.
-
Hemorrhagic Stroke (13%): Caused by bleeding.
- Intracerebral: Bleeding within the cerebrum.
- Subarachnoid: Bleeding between the arachnoid and pia mater layers.
"Complete" Stroke
- A "complete stroke" implies no further neurological damage and vital signs are stabilizing.
- This is in contrast to a stroke in evolution where damage is still occurring.
Priority Nursing Consideration Post-Stroke
- Airway clearance is the priority immediate post-stroke nursing concern.
Stroke Stages
-
Acute Phase (Stroke in Evolution): Damage is ongoing.
- Visual loss on one side should be considered. If right-sided loss, protect the patient's left side.
-
Rehab Phase (Complete Stroke): No further damage.
- Support is now for deficits, such as retraining for use of affected limbs or sides.
Tissue Plasminogen Activator (tPA) Administration in CVA
- Effective window for tPA administration: 3 hours.
Calcium Channel Blocker (Nimodipine) Administration
- Vital signs (blood pressure and pulse) should be checked right before administration.
Loop Diuretics and Dietary Management
- Foods rich in potassium (bananas, spinach, potatoes) will help manage potential adverse effects of loop diuretics.
Beta-Adrenergic Blockers and Potential Adverse Effects
- Diabetes Management: Beta-blockers can impact blood sugar.
- Fall Risk: Orthostatic hypotension (sudden drop in blood pressure when standing) is a potential side effect; this can increase fall risk.
- Hypoglycemia: Low blood sugar could result.
Verapamil (Calcium Channel Blocker) Patient Education
- Orthostatic Hypotension: Educate patients on the risk of sudden drops in blood pressure when standing.
- Pulse Monitoring: Teach patients to check their pulse before taking the medication.
ACE Inhibitors and Reduced Immunity
- ACE inhibitors (end in -pril) may reduce immunity. Monitor their neutrophil count and notify the doctor. Scheduling follow-up lab work is crucial.
Sodium-Restricted Diet and Salt Substitutes
- Garlic can be a safe alternative to regular salt.
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Description
This quiz covers the symptoms and implications of cerebrovascular accidents (CVA) and transient ischemic attacks (TIA). You will learn about the different types of strokes, their causes, and the treatment options such as anticoagulants like Coumadin/Warfarin. Improve your understanding of brain injuries and their impact.
