N213: Health Differences Across the Life Span 3

N213: Health Differences Across the Lifespan 3 Study Guide Expected outcomes for head injury: • Able to maintain patent airway, clearance of secretions, and effective gas exchange • Patient remains free of complications: increased ICP, seizures, and infection • Verbalizes or demonstrates comfort and pain reduction • Maintains fluid balance, electrolyte balance, and nutritional status WNL • Patient and/or family verbalize understanding of injury, treatment, safety, and prognosis Cerebrovascular Accident This condition is also known as a stroke, or CVA for short. It happens when the blood supply to an area of the brain is cut off (cerebral ischemia). This happens due to hemorrhage, venous thrombosis (blood clot), or an embolism (air or fat). When the arteries are hardened due to atherosclerosis, they are unable to stretch with increased pressure. It happens mostly in the middle cerebral artery and internal carotid arteries near the base of the brain. CVA happens because of embolism or thrombosis over 80% of the time, but the biggest cause is cerebral thrombosis. In thrombosis, the arteries build up plaque slowly over time (atherosclerosis). Hypotension causes symptoms and they occur while the patient is resting. Embolism causes the second highest amount of infarction. Embolism happens suddenly and is due to an embolus from another part of the body. It most often occurs at the end of the day. Lastly, hemorrhage causes about 15% of strokes. Hemorrhages causing strokes are usually from a ruptured aneurysm, head injury, or uncontrolled high blood pressure. They are very emergent and highly fatal if left untreated. Some people who are about to experience a CVA have small attacks preceding the major one. They are temporary ischemic attacks or TIA. These can have temporary loss of neurological function, loss of consciousness, seizure, and fainting spells. If these episodes last longer than a few minutes, then the brain tissue begins to die off. Once this happens, the neurological impairment becomes permanent. Signs and symptoms of TIA (transient ischemic attack): • Vertigo • Temporary paralysis to one side of the body • Tinnitus (ringing in the ears) • Mental status changes Signs and symptoms occurring with most cerebral vascular accidents: • Headache • Confusion • Decreased motor control • Hyper/hypo reflexes • Impaired memory • Decreased perception • Poor judgement • Problems speaking • Cardiac dysrhythmia • Forgetful of learned actions ©2017 Achieve Test Prep Page 109 of 204