Stroke quiz

What type of stroke education have you received?

• Mandatory annual stroke, education or for new to stroke care Nurses comprehensive classes.

• NIHSS certification/NIHSS refresher

• Competency (2023 STK core, measure compliance, swallow screen individualizing POC//education to the patient)

• Annual required education (Hospital wide) includes BEFAST and what to do if symptoms of stroke are noted.

What is the most common stroke mimic?

• Hypoglycemia

• Hypertension

• Encephalopathy

• A very tired person who has sat in the ER all night.

What is the target for blood glucose after stroke? Hyperglycemia and hypoglycemia are associated with poor clinical outcomes.

• 70- 160

• >70

• 140- 180

• 80 - 120

What is the temperature we target for strokes? Why?

• Less than 37°C, keeping a patient normal thermic will reduce metabolic demand saving brain

• Less than 38°C, keeping a patient’s temperature low will reduce metabolic demand saving brain.

• Less than 36°C, keeping a patient hypothermic will reduce metabolic demand saving brain

Per joint commission what are the education topics that must be covered with patient and family?(Select all that apply)

• Modifiable risk factors

• Call 911 for any signs of stroke

• The importance of follow up appointments

• Signs and symptoms of stroke (BEFAST)

• The importance of taking prescribed medication.

What does BEFAST stand for?

• Blood sugar, eyes, face, arm, speech, time

• Blood pressure, eyes, face, arm, swallow, time

• Balance, eyes, face, arm, speech, time

• Balance, eyes, face, arm, swallow, time

What are the SBP targets for ischemic strokes?

No TNK?

Post TNK?

• <200/100 (permissive hypertension)

  <180/105 (up to 24 hours post TNK)

• <220/100 (permissive hypertension)

  <180/90 (up to 24 hours post TNK)

• <180/100 (permissive hypertension)

  <160/90 (up to 24 hours post TNK)

• <220/120 (permissive hypertension)

  <180/105 (up to 24 hours post TNK)

What is the target INR for hemorrhagic strokes? What are the reversal agents for elevated INR?

• <1.3

  For INR >\= 1.4 - FFP, K centra, Factor 7

• <1.4

  For INR >\= 1.4 - FFP, K centra, platelets

• <1.7

  For INR >\= 1.7 - FFP, K centra, Factor 7

• <1.4

  For INR >\= 1.4 - FFP, cryoprecipitate, platelets

What are the systolic blood pressure targets for

ICH?

Spontaneous SAH?

• 160 < SBP > 100

  SBP < 150

• 180 < SBP > 110

  SBP < 150

• 160 < SBP > 100

  SBP < 180

• 180 < SBP > 110

  SBP < 180

A patient taking an ACE inhibitor is at higher risk for what adverse side effect post TNK?

• Petechia

• Hematuria

• AKI

• Angioedema