Stroke Treatment and Diagnosis

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Questions and Answers

Which factor does not contribute to the prevention of stroke?

Maintaining a healthy weight

Exercising regularly

Lowering dietary intake of fiber (correct)

Controlling high blood pressure

What is the primary goal of acute care for stroke patients?

To enhance brain injury and restore prior functioning

To minimize brain injury and maximize recovery (correct)

To ensure long-term rehabilitation success

To stabilize chronic conditions like diabetes

Which of the following is an essential step in the acute care stage for stroke management?

Long-term lifestyle changes

Regular follow-ups at a stroke center

Immediate recognition and response to stroke symptoms (correct)

Continuous observation of heart rate

What does the National Institutes of Health Stroke Scale assess?

Neurologic outcome and degree of recovery Signup and view all the answers

Which imaging test is primarily used to assess damage after a stroke?

CT scans Signup and view all the answers

What is a critical component when diagnosing a stroke?

Assessment of stroke symptoms' onset time Signup and view all the answers

Which of the following is not one of the measures taken in acute stroke care?

Immediate surgical intervention in all cases Signup and view all the answers

What role does rehabilitation play after a stroke?

It involves various specialized therapies for recovery Signup and view all the answers

Why should anticoagulant and antiplatelet medications never be given to a patient with a hemorrhagic stroke?

They may increase the risk of harmful bleeding. Signup and view all the answers

What is the maximum permissible systolic blood pressure for a patient eligible for thrombolytic therapy with IV tPA?

185 mmHg Signup and view all the answers

Which medication may be prescribed to manage cerebral edema in stroke patients?

Mannitol Signup and view all the answers

What is the primary action of tissue plasminogen activator (tPA) in stroke treatment?

Converts plasminogen to plasmin. Signup and view all the answers

How long after symptom onset is alteplase most effective when used to treat ischemic stroke?

3 hours Signup and view all the answers

What should be monitored continuously in a patient receiving tPA therapy to watch for complications?

Neurovascular status Signup and view all the answers

What is a common complication of tPA therapy?

Brain hemorrhage Signup and view all the answers

What dietary advice should patients receiving tPA follow?

Avoid foods that influence clotting Signup and view all the answers

Which surgical procedure may be performed to treat significant atherosclerosis in stroke patients?

Carotid endarterectomy Signup and view all the answers

Why is blood pressure control important during the acute phase of stroke?

To prevent bleeding during thrombolytic therapy Signup and view all the answers

What informs the decision to perform an extracranial–intracranial bypass?

TIAs or a mild completed stroke Signup and view all the answers

What is an essential nursing action before administering tPA?

Monitor blood pressure. Signup and view all the answers

When should patients ideally receive tPA after arriving in the emergency department?

90 minutes Signup and view all the answers

What type of stroke is characterized by an immediate appearance of clinical symptoms?

Hemorrhagic stroke Signup and view all the answers

What imaging test can identify cerebral ischemia immediately after stroke onset?

Diffusion-weighted imaging Signup and view all the answers

Which medication is commonly used to prevent clot formation in patients with a history of stroke?

Aspirin Signup and view all the answers

What is the recommended timeframe for administering tPA for optimal effectiveness in treating acute ischemic stroke?

Within 3 hours Signup and view all the answers

What type of drug is generally prescribed to manage high blood pressure in the context of stroke prevention?

Antihypertensives Signup and view all the answers

Which of the following tests is NOT included in imaging techniques for stroke diagnosis?

Blood lipid panel Signup and view all the answers

Which medication class is considered standard for cholesterol management in stroke prevention?

Statins Signup and view all the answers

What should be avoided in patients with increased intracranial pressure (ICP)?

Lumbar puncture Signup and view all the answers

What therapy is recommended for patients with atrial fibrillation to prevent stroke?

Vitamin K antagonists Signup and view all the answers

What effect does daily low-dose aspirin have for patients with TIAs?

Reduces risk of stroke by platelet aggregation interference Signup and view all the answers

Which of the following is considered a contraindication for tPA administration?

History of both diabetes and prior stroke Signup and view all the answers

In terms of stroke prevention, what is the primary effect of antihypertensive medications?

Reducing blood pressure Signup and view all the answers

What type of stroke is the use of thrombolytic agents particularly indicated for?

Thrombotic stroke Signup and view all the answers

Which of the following medications is a direct thrombin inhibitor used for stroke prevention?

Dabigatran Signup and view all the answers

Study Notes

Stroke Treatment Stages

Stroke treatment consists of three stages: prevention, acute care, and rehabilitation.
Prevention focuses on managing risk factors like high blood pressure, cholesterol, diabetes, smoking, and maintaining a healthy weight.
Acute care aims to diagnose the stroke type, support brain circulation, and prevent further complications.
Rehabilitation focuses on recovery and regaining lost function through specialized therapy.

Diagnosing a Stroke

Stroke diagnosis involves observation, patient history, a physical examination, including a neurological assessment, and imaging tests.
The National Institutes of Health Stroke Scale (NIHSS) assesses neurological function and recovery.
Imaging tests, including CT scans, MRI, and cerebral arteriography, help identify stroke-related changes and differentiate between hemorrhagic and ischemic strokes.
Blood tests, like the PLAC test, are used to assess the risk for recurrent stroke.

Medications for Stroke Prevention

Antiplatelet agents like aspirin and clopidogrel are used to reduce the risk of stroke in individuals with a history of TIAs or stroke.
Anticoagulants like warfarin, rivaroxaban, apixaban, edoxaban, and dabigatran are prescribed to prevent stroke in patients with atrial fibrillation.
Antihypertensive medications, including thiazide diuretics, calcium channel blockers, ACE inhibitors, and ARBs, are used to manage high blood pressure and reduce stroke risk.
Cholesterol-lowering drugs, such as statins and fibric acid agents, are prescribed to manage high cholesterol levels.

Medications for Acute Stroke

Anticoagulants, platelet inhibitors, and thrombolytic agents are used to treat thrombotic strokes.
Thrombolytic therapy with alteplase (tPA) is considered the gold standard for treating acute ischemic stroke.
tPA is most effective when administered intravenously within 3 hours of stroke onset, but can be given up to 4.5 hours in specific cases.
Aspirin may be used in patients who are contraindicated for tPA.
Anticoagulants and antiplatelet agents are not used in patients with hemorrhagic stroke.
Corticosteroids, such as prednisone or dexamethasone, may be prescribed for cerebral edema.
Osmotic diuretics (mannitol) and loop diuretics (furosemide) may be given for increased intracranial pressure.
Anticonvulsants, such as phenytoin and barbiturates, may be prescribed for seizures related to increased ICP.

Surgical Interventions

Carotid endarterectomy is a surgical procedure to remove atherosclerotic plaque from the carotid artery bifurcation to improve blood flow.
Extracranial-intracranial bypass surgery is performed to re-establish blood flow to the brain in cases of occluded or stenotic vessels.
Carotid angioplasty with stenting can be used to treat cerebral stenosis.

Rehabilitation Therapies

Physical therapy focuses on preventing contractures, improving muscle strength, and enhancing coordination.
Occupational therapy helps patients regain lost motor skills, such as eating, bathing, and dressing.
Speech and language therapy assists with relearning language and communication skills, as well as improving swallowing.

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Description

This quiz covers the three essential stages of stroke treatment: prevention, acute care, and rehabilitation. It also delves into the methods used for diagnosing a stroke, including the importance of imaging tests and neurological assessments. Test your understanding of stroke management and recovery processes.