NCLEX Review & Nursing School

Stroke

is also called a cerebrovascular accident (CVA).  There could be an obstruction of arterial blood flow (ischemic stroke) such as a blood clot, and it can also be a ruptured blood vessel (hemorrhagic stroke).

• Assessment
• Mental Impairment
• Disorientation, confusion

There are two types of strokes being ischemic and hemorrhagic.

Ischemic

• There is some kind of disruption of blood flow in the brain causing a decrease in oxygenation to the brain. Usually caused by an embolus or thrombosis
• A Carotid Endarterectomy may be done. ( A plaque is removed from the carotid artery)

Hemorrhagic

• Usually caused by a ruptured aneurysm or and AVM (Arteriovenous Malformation), which can be due to hypertension.



Diagnostic Tests:

• CT scan and MRI would usually reveal either bleeding (hemorrhagic) or an occlusion or a narrowing (thrombolytic).

Treatments:

• Anticoagulants: Heparin, Warfarin (Coumadin), Ticlopidine
• Anticonvulsants: Phenytoin (Dilantin)
• Thrombolytic Therapy: Tissue Plasminogen Activator is given.
• Glucocorticoids: Dexamethasone

Interventions:

• Elevate the head of the bed 30 degrees.
• Monitor neurological status

Hemianopsia– client has a blindness in half the visual field.

Homonymous Hemianopsia– is blindness in the same visual field of both eyes.

• If patient has Hemianopsia, encourage the client to turn head in a full range from either left to right or the opposite, in order to see the complete range of vision.