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Ashley Shared "PN 224 Week 11" - 6 Picmonics

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PN 224 Week 11

Types of Strokes
Warning Signs
Transient Ischemic Attack (TIA)
Reversible Ischemic Neurologic Deficit (RIND)
Types
Ischemic
Thrombotic
Atherosclerosis
Embolic
Atrial Fibrillation
Hemorrhagic
Severe Hypertension
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3 mins
Right Hemisphere Stroke Assessment
Opposite Side Weakness (Hemiplegia)
Poor Proprioception
Disoriented to Person, Place, Time
Can't Recognize Faces (Prosopagnosia)
Loss of Judgement and Awareness
Impulsiveness
Personality Changes
Tonal Hearing Loss
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2 mins
Left Hemisphere Stroke Assessment
Opposite Side Weakness (Hemiplegia)
Side to Side Discrimination
Aphasia
Agraphia
Slow Performance
Aware of Deficits
Anxiety
Depression
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2 mins
Stroke Management
1) Non-contrast CT
A) If hemorrhagic:
Keep BP below 160/105
Nitroprusside
Reverse anticoagulation
Consult neurosurgery
NIH Stroke Scale
Supplemental O2
2) Ischemic stroke/TIA
Keep below 220 over 120
Pressors MAP under 60 or SBP under 90
Decide if tPA indicated
IF tPA contraindicated, give aspirin/clopidogrel
Long-term treatment
Workup/management (within days of stroke)
1) EKG
If AFIB present
Warfarin or LMWH
2) Echocardiogram
Heparin-warfarin bridge if thrombus present
3) Carotid artery ultrasound
If over 70 percent occluded AND symptomatic
OR just 80 percent occlusion
Carotid endarterectomy
Aspirin for everyone (long term)
Statin (everyone)
Labetalol, nicardipine
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Ischemic stroke management
<3 hrs tx. is thrombolytics
tPA (tissue plasminogen)
> 3hrs tx. anti-platelets
Aspirin + dipyridamole
Clopidogrel (Plavix)
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hemorrhagic stroke symptoms
Basal ganglia
basal ganglia
conjugate gaze palsy
homonymous hemianopia
Cerebellar
cerebellar
ataxia
occipital headache
nystagmus
Thalamic
thalamus
upgaze palsy
miotic pupils
eyes deviate Towards hemiparesis
Pons
pons
pinpoint pupils
coma
paralysis
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