med surg exam 2

A client is being discharged from the Emergency Department after being diagnosed with a sprained ankle. Which client statement indicates the client understands the discharge teaching?

"I'll make sure to keep my ankle elevated as much as possible."

The nurse is providing instructions to the client who is being prepared for skeletal traction. Which statement by the client indicates teaching was effective?

"Metal pins will go through my skin to the bone."

Which instruction should the nurse include when teaching the client following hip replacement surgery? (Select all that apply.)

"Place pillows between your legs when you lay on your side." "Avoid bending forward when sitting in a chair." "Use a raised toilet seat and high-seated chair."

epilepsy is ____ or more unprovoked seizures

2

epilepsy

2 or more unprovoked seizures

perfect GCS

4,5,6 15

status epliepticus

5 or more minutes of seizure activity can result from hepatic encepahlopty, meningitis. treatment: lorazepam, valium, keppra, topamax, dilantin if caused by hypoglycemia, give IV dextrose 50% give IV thiamine for alcohol withdrawal

Which interventions should a nurse implement as part of initial pain relief for the client with a cast? Select all that apply.

Apply cold packs Administer analgesics Elevate the involved part

A nurse is caring for a patient diagnosed with a hemorrhagic stroke. When creating this patient's plan of care, what goal should be prioritized? A)Prevent complications of immobility. B)Maintain and improve cerebral tissue perfusion. C)Relieve anxiety and pain. D)Relieve sensory deprivation.

B

Following a spinal cord injury a patient is placed in halo traction. While performing pin site care, the nurse notes that one of the traction pins has become detached. The nurse would be correct in implementing what priority nursing action? A)Complete the pin site care to decrease risk of infection. B)Notify the neurosurgeon of the occurrence. C)Stabilize the head in a lateral position .D)Reattach the pin to prevent further head trauma.

B

The nurse is participating in the care of a patient with increased ICP. What diagnostic test is contraindicated in this patient's treatment? A) Computed tomography (CT) scan B) Lumbar puncture C) Magnetic resonance imaging (MRI) D) Venous Doppler studies

B

The nurse is planning the care of a patient with Parkinson's disease. The nurse should be aware that treatment will focus on what pathophysiological phenomenon? A)Premature degradation of acetylcholine B)Decreased availability of dopamine C)Insufficient synthesis of epinephrine D)Delayed reuptake of serotonin

B

As a member of the stroke team, the nurse knows that thrombolytic therapy carries the potential for benefit and for harm. The nurse should be cognizant of what contraindications for thrombolytic therapy? Select all that apply. A)INR above 1.0 B)Recent intracranial pathology C)Sudden symptom onset D)Current anticoagulation therapy E)Symptom onset greater than 3 hours prior to admission

B, D, E

A clinic nurse is caring for a patient with a history of osteoporosis. Which of the following diagnostic tests best allows the care team to assess the patients risk of fracture? A) Arthrography B) Bone scan C) Bone densitometry D) Arthroscopy

C

The nurse is caring for a patient diagnosed with an ischemic stroke and knows that effective positioning of the patient is important. Which of the following should be integrated into the patient's plan of care? A)The patient's hip joint should be maintained in a flexed position. B)The patient should be in a supine position unless ambulating. C)The patient should be placed in a prone position for 15 to 30 minutes several times a day. D)The patient should be placed in a Trendelenberg position two to three times daily to promote cerebral perfusion.

C

what diagnostic test should be used to confirm a hemmorhagic stroke?

CT or MRI

A patient with a cerebral aneurysm exhibits signs and symptoms of an increase in intracranial pressure (ICP). What nursing intervention would be most appropriate for this patient? A)Range-of-motion exercises to prevent contractures B)Encouraging independence with ADLs to promote recovery C)Early initiation of physical therapy D)Absolute bed rest in a quiet, nonstimulating environment

D

What should be included in the patient's care plan when establishing an exercise program for a patient affected by a stroke?A)Schedule passive range of motion every other day. B)Keep activity limited, as the patient may be over stimulated .C)Have the patient perform active range-of-motion (ROM) exercises once a day. D)Exercise the affected extremities passively four or five times a day.

D

Which of the following disorders results in widespread hemorrhage and microthrombosis with ischemia?

DIC

ischemic stroke

Disruption of the blood supply caused by an obstruction, usually a thrombus or embolism, that causes infarction of brain tissue' LAT, SPAT, cardiogenic embolism, cryptogenic -numbness or weakness of the face, arm, or leg. -confusion/change in mental status -motor, sensory, visual field, emotional deficits -trouble speaking or understanding speech -visual disturbances -difficulty walking, dizziness, loss of balance or coordination TREATMENT: TPA. should not be given for hemorrhagic stroke.

how are seizures diagnosed?

EEG (electroencephalogram)

What is the best action by the nurse to achieve optimal outcomes when caring for a client with a musculoskeletal disorder who is using a cast?

Educate the client about cast care and complications

t or f: a patient with a hemorrhagic stroke CAN receive TPA

FALSE, tpa increases bleeding.

treatment for bacterial meningitis

Iv antibiotics 2 weeks followed by PO antibiotic give mannitol to reduce cerebral edema

A nurse is working with a student nurse who is caring for a client with an acute bleeding cerebral aneurysm. Which action by the student nurse requires further intervention?

Keeping the client in one position to decrease bleeding

Homonymous hemianopsia (loss of half of the visual field)

Place objects within intact field of vision. Approach from side of intact field of vision. Instruct/remind the patient to turn head in the direction of visual loss to compensate for loss of visual field. Use eyeglasses When educating the patient, do so within patient's intact visual field.

which type of arthritis is characterized by joint stiffness in the mornings?

RA

A client is placed in traction for a femur facture. The nurse would document which expected outcomes of traction? Select all that apply.

Realignment of the fracture Reduction of deformity Minimization of muscle spasms

A nurse is teaching a community class that those experiencing symptoms of ischemic stroke need to enter the medical system early. The primary reason for this is which of the following?

TPA has a time window of only 3 hours

Which client(s) is most likely to have compartment syndrome after sustaining a fracture? Select all that apply.

The client with elevated pressure within the muscles The client with hemorrhage in the site of injury The client with a plaster cast applied immediately after injury

Which statement describes external fixation?

The surgeon inserts metal pins into the bone or bones from outside the skin surface and then attaches a compression device to the pins.

The older client asks the nurse how best to maintain strong bones. What is the nurse's best response?

Weight bearing exercises can strengthen bones

A patient is brought by ambulance to the ED after suffering what the family thinks is a stroke. The nurse caring for this patient is aware that an absolute contraindication for thrombolytic therapy is what?A)Evidence of hemorrhagic stroke B)Blood pressure of ³ 180/110 mm Hg C)Evidence of stroke evolution D)Previous thrombolytic therapy within the past 12 months

a

A client with suspected osteomalacia has a fractured tibia and fibula. What test would give a definitive diagnosis of osteomalacia?

a bone biopsy

which cardiac dysrhythmia is associated with cardiogenic embolic strokes?

a fib

A spiral fracture should make you think of what issue?

abuse

A client has undergone arthroscopy. After the procedure, the site where the arthroscope was inserted is covered with a bulky dressing. The client's entire leg is also elevated without flexing the knee. What is the appropriate nursing intervention required in caring for a client who has undergone arthroscopy?

apply a cold pack at the insertion site

A client has severe osteoarthritis in the left hip and is having surgery to replace both articular surfaces of the hip. What type of surgical procedure will the nurse prepare the client for?

arthroplasty

A patient is scheduled for a total hip replacement and the surgeon has explained the risks of blood loss associated with orthopedic surgery. The risk of blood loss is the indication for which of the following actions?

autologus blood donation

Which of the following is the most appropriate nursing intervention to facilitate healing in a patient who has suffered a hip fracture? A) Administer analgesics as required .B) Place a pillow between the patients legs when turning. C) Maintain prone positioning at all times. D) Encourage internal and external rotation of the affected leg

b

open (compound) fracture

bone breaks through the skin increased risk for infection

osteogenesis

bone formation

ossification

bone matrix formed, hardened by calcium, and hydroapetite are bound to collagen fibers

Osetoarthritis

bone spurs, inflammation, and limited mobility crepitus, loss of function, herberdens nodes (DIPJ), bouchanders nodes (PIPJ) risk factors: females, old age, smoking, obesity, repetitive stress on joints

CAE

carotid endarterectomy removes atheroasclerotic plaques or thrombus seen in ischemic stroke

CEA

carotid endarterectomy - removal of atherosclerotic plaque from CA indicated for patients with symptoms of TIA or mild stroke with 70-90% CAS OR 50-69% stenosis with other risk factors

modifiable risk factors for ischemic stroke

carotid stenosis A fib Diabetes Dyslipidemia Excessive alcohol consumption hypertension Obesity Sedentary lifestyle Sleep apnea smoking

CVA

cerebrovascular accident (stroke) sudden interruption of blood supply to the brain causes: atherosclerosis, kidney disease, AFIB (stagnant blood in atrial-- embolic stroke), high serum triglycerides, smoking, family h/o stroke -classified as course of progression: tia (temporary loss of BS), thrombis, completed stroke (maximal)

rheumatoid arthritis (RA)

chronic progressive AI disease that causes inflammation, thickening, and deformation of the joints bilaterally and symmetrically -antibodies attack the joint synovium

meningitis symptoms

classic triad of headache, neck stiffness and fever -photophobia, petechial rash, altered mental status

embolic stroke

clots travel from a certain part of the body into the brain

expressive aphasia

damage to brocas area (Frontal lobe) pt can understand but not communicate

receptive aphasia

damage to wernickes area (tempoparietal lobe) pt understand spoken and written words

electromyography

detects muscle weakness needle is inserted into muscle and electrical activity is recorded

factors that inhibit fracture healing include

diabetes, smoking, local malignancy, bone loss, extensive local trauma, age greater than 40, and infection.

closed (simple) fracture

does not break the skin

lordosis

exaggerated curvature of the lumbar spine

viral meningitis is most common in

immunocompromised patients those who are HIV + and may have cancer

non union of bone may be caused by...

improper splinting

goal of a hemorrhagic stroke

improve cerebral tissue perfusion

TPA

only FDA treatment used for ischemic stroke must be used w/in 3 hours monitor for s/s of BLEEDING

which cells are involved in bone resorption

osteoclasts

A fib increases risk for

thrombotic stroke

tonic-clonic seizure

tonic: stiffening of muscles, loss of consciousness clonic: 1-2 minutes of rhythmic jerking of the extremities postictal phase: tiredness, confusion, agitation

t or f: osteoarthritis is relieved WITH exercise

true

t or f: patients with RA are more likely to get sjorens syndrome

true

t or f: symptoms seen in a TIA usually resolve 1-2 hours after event

true

CPM

use immediately after surgery promotes healing by increasing circulation and movement of the knee joit

A client with low back pain is being seen in the clinic. In planning care, which teaching point should the nurse include?

use the large muscles of the leg when lifting

bryants traction

used for hip dysplasia in children

A nurse is caring for a patient who had a right below-the-knee amputation (BKA). The nurse recognizes the importance of implementing measures that focus on preventing flexion contracture of the hip and maintaining proper positioning. Which of the following measures will best achieve these goals? A) Encouraging the patient to turn from side to side and to assume a prone position B) Initiating ROM exercises of the hip and knee 10 to 12 weeks after the amputation C) Minimizing movement of the flexor muscles of the hip D) Encouraging the patient to sit in a chair for at least 8 hours a day

A

A patients fracture is healing and callus is being deposited in the bone matrix. This process characterizeswhat phase of the bone healing process? A) The reparative phase B) The reactive phase C) The remodeling phase D) The revascularization phase

A

The patient has been diagnosed with aphasia after suffering a stroke. What can the nurse do to best make the patient's atmosphere more conducive to communication? A)Provide a board of commonly used needs and phrases. B)Have the patient speak to loved ones on the phone daily. C)Help the patient complete his or her sentences .D)Speak in a loud and deliberate voice to the patient.

A

The patient in the ED has just had a diagnostic lumbar puncture. To reduce the incidence of a post-lumbar puncture headache, what is the nurse's most appropriate action? A)Position the patient prone. B)Position the patient supine with the head of bed flat. C)Position the patient left side-lying. D)Administer acetaminophen as ordered.

A

The nurse caring for a patient in a persistent vegetative state is regularly assessing for potential complications. Complications of neurologic dysfunction for which the nurse should assess include which of the following? Select all that apply. A) Contractures B) Hemorrhage C) Pressure ulcers D) Venous thromboembolism E) Pneumonia

A C D E

The nurse is assessing a patient for dietary factors that may influence her risk for osteoporosis. The nurse should question the patient about her intake of what nutrients? Select all that apply. A) Calcium B) Simple carbohydrates C) Vitamin D D) Protein E) Soluble fiber

A and C

The nurse is providing care for a patient who has had a below-the-knee amputation. The nurse enters the patients room and finds him resting in bed with his residual limb supported on pillow. What is the nurses most appropriate action? A) Inform the surgeon of this finding. B) Explain the risks of flexion contracture to the patient. C) Transfer the patient to a sitting position. D) Encourage the patient to perform active ROM exercises with the residual limb.

B

A patient is admitted to the neurologic ICU with a spinal cord injury. In writing the patient's care plan, the nurse specifies that contractures can best be prevented by what action? A)Repositioning the patient every 2 hours B)Initiating range-of-motion exercises (ROM) as soon as the patient initiates C)Initiating (ROM) exercises as soon as possible after the injury D)Performing ROM exercises once a day

C

A patient is exhibiting classic signs of a hemorrhagic stroke. What complaint from the patient would be an indicator of this type of stroke? a) Dizziness and tinnitus b) Numbness of an arm or leg c) Severe headache d) Double vision

C

rheumatoid arthritis

a chronic autoimmune disorder in which the joints and some organs of other body systems are attacked -excarebations and remissions -edema, inflammation, bone thickening, deformation of joints bilaterally and symmetrically, morning stiffness, fever, red sclera, ulnar drift, risk factors: female, age 20-50, family history

complex partial seizure

a partial seizure, starting from a focus and remaining localized, that produces loss of consciousness altered behavior, looses consciousness for a few seconds

A patient exhibiting an altered level of consciousness (LOC) due to blunt-force trauma to the head is admitted to the ED. The physician determines the patient's injury is causing increased intracranial pressure (ICP). The nurse should gauge the patient's LOC on the results of what diagnostic tool? A) Monro-Kellie hypothesis B) Glasgow Coma Scale C) Cranial nerve function D) Mental status examination

c

A patient with Parkinson's disease is undergoing a swallowing assessment because she has recently developed adventitious lung sounds. The patient's nutritional needs should be met by what method? A)Total parenteral nutrition (TPN) B)Provision of a low-residue diet C)Semisolid food with thick liquids D)Minced foods and a fluid restriction

c

a glasgow coma scale of less than 8 indicates

coma

emergency fracture care

cut clothing, remove jewelery, control bleeding, immobilize fracture by proper splinting assess for numbness, tingling, and lack of sensation, cap refill, pulses distal. focus on pulses DISTAL TO THE FRACTURE SITE! monitor for FES, CS. increase fluid intake, use SCDs.

A male patient with a metastatic brain tumor is having a generalized seizure and begins vomiting. What should the nurse do first?A)Perform oral suctioning. B)Page the physician. C)Insert a tongue depressor into the patient's mouth .D)Turn the patient on his side.

d

Impaired balance and uncontrolled tremors of Parkinson's disease is correlated with which neurotransmitter?

dopamine

The nurse is performing an assessment for a patient in the clinic with Parkinson's disease. The nurse determines that the patient's voice has changed since the last visit and is now more difficult to understand. How should the nurse document this finding?

dysphonia

atonic seizures often result in

falling

Fat embolism

fat embolism from the bone travels to the lungs most common with long bones and hip fractures dyspnea, tachypnea, tachycardia, chest pain, fever, decreased 02, petechial rash

risk factors for seizure disorder

fever, cerebral edema, infection, toxin exposure, brain tumor, hypoxia, alcohol/drug withdrawal, F&E imbalances

Dupuytren contracture causes flexion of which area(s)?

fifth and fifth fingers

Aneurysm rebleeding occurs most frequently during which time frame after the initial hemorrhage?

first 2-12 h

A patient has had a stroke and is unable to move the right upper and lower extremity. During assessment the nurse picks up the arm and it is limp and without tone. How would the nurse document this finding?

flaccidity

contraindications for TPA

head trauma/stroke past 3 mo symptoms or h/o cerebral hemorrhage arterial puncture at a non-compressible site w/in 7 days systolic 185> or diastolic 110> any bleeding on present examination had hepain in past 24 hrs INR greater than 1.7 or PT 15> BG less than 50 CT multilobar infarction NOT FOR HEMORRHAGIC STROKE

initial symptoms of meningitis

headache and fever

two most serious complications of a pelvic fracture

hemorrhage and stroke

a severe headache is common in what kind of stroke?

hemorrhagic

kyphosis

hunchback, exaggerated thoracic curvature

most common cause of hemorrhagic stroke

hypertension

what is the most common cause of hemmorhagic stroke?

hypertension

FES Classic Triad

hypoxemia, neurologic compromise, and a petechial rash

A client has been in a motor vehicle collision. Radiographs indicate a fractured humerus; the client is awaiting the casting of the upper extremity and admission to the orthopedic unit. What is the primary treatment for musculoskeletal trauma?

immobilization

treatment of musculoskeletal trauma involves __________ of the injured area until it has healed

immobilization

viral meningitis is most common in

immunocompromised patients

goals of parkinson treatment

improve function bladder and bowel maintenance nutrition improve mobility prevent complications

kernig sign

inability to fully extend the knees with hips flexed.

patients with ischemic stroke should do what....

incentive spirometry to prevent pneumonia wear SCDs turned and repositioned q2h

compartment sydrome

increased pressure within the muscle compartment of an extremity impairs circulation treatment: avoid use of cold, open/bivalving cast, keep limb at heart level, fasciotomy, amputation

cloudy CSF may indicate

infection

osteomyelitis

infection of the bone decreased BF to bone and therby causing bone necrosis -rf: open fractures, ortho surgery, diabetes, catheters, IV, peridontal disease. -GOAL: get IV or urinary catheter out ASAP. ss: bone pain, increased WBC, erythema. treatment: debridement, hyperbaric o2 therapy

arthroscopy

internal visualization of the internal joint structure and allows for the collection of biopsies -contraindicated for infection OR if pt cannot bend joint 40>

for patients who have gotten an arthroplasty, when should patients take antibiotics?

invasive procedures/dental work

CEA and CAS are indicated for what type of stroke?

ischemic

What finding correlates with osteoarthritis?

joint stiffness that decreases with activity

what position should the patient be in for CSF draw?

lateral decubitus (fetal position) OR leaning over the edge of the bed.

scoliosis

lateral deviation of the spine

atonic seizure

loss of muscle tone increased risk for falling

A client with a traumatic brain injury is showing early signs of increasing intracranial pressure (ICP). While planning care for this client, what would be the priority expected outcome?

maintaining a patent airway

The nurse is caring for a client diagnosed with a hemorrhagic stroke. The nurse recognizes that which intervention is most important?

maintaining a patent airway

dexascan

measures bone mass used to diagnosis osteoporosis

Septic meningitis

meningitis caused by bacteria ONLY, associated with strep pneumoniae or neiserria meningitidis

prevention of meningitis

meningococcal conjugated vaccine be given to youth at 11 to 12 years of age booster dose at 16 years of age. -individuals in contact w patient should begin rocephin 24 hrs afters expoure

traction

minimize muscle spasms, to reduce, align, and immobilize fractures, and to reduce deformity.

arthroplasty

monitor for signs and symptoms of thromboembolism monitor for infection, bleeding, and neurovascular compromise take antibiotics before dental work or invasive procedures

if a patient has RA the nurse should...

monitor for sjorens syndrome

hemorrhagic stroke nursing interventions

monitor neuro deteroration seizure precautions preventing secondary injuries -hypoxia, DVT, pneumonia, aspiration, skin breakdown, UTI

patient teaching for amputation

never put a pillow below the stump avoid elevating the stump perform ROM exercises chair sitting 1h> lie prone on stomach, 2-4 h post op

early sign of meningitis

nuchal rigidity

patient presentation of hemorrhagic stroke

nuchal rigidity and severe headachve

ischemic/hemorrhagic stroke

numbness/tingling of face, arm, or leg confusion change in LOC motor, sensory, visual or emotional deficits trouble speaking OR understanding speech visual disturbances difficulty walking, dizziness, loss of balance.

aseptic meningitis

occurs more frequently in the summer and early fall.

hemorrhagic stroke

occurs when a blood vessel in the brain leaks or ruptures; also known as a bleed 3 main symptoms: altered LOC, nuchal rigidity, sudden severe headache altered level of consciousness, sluggish pupillary reaction, motor/sensory dysfunction, speech and visual disturbances, and headache

risk factors osteoarthritis

old age, females, obesity, smoking, repetitve stress on joint.

ORIF

open reduction internal fixation involves metal plates, screws, rods, and pins

A client presents to the emergency department with fever, chills, restlessness, and limited movement of a fractured jaw. What complication should the nurse interpret as the findings?

osteomyelitis

teaching during seizure

padded side rails, oral airway at bedside, "aura" place oral airway. suction at bed side and o2 at bed side loosen restrictive clothing. put on side to prevent aspiration place pillow under head clear hard objects time seizure. reassure patient that he/she is alright, reorient to time and place, and that he/she has experienced a seizure

Brudzinski's sign

pain with resistance and involuntary flex of hip/knee when neck is flexed to chest when lying supine

Abnormal sensations, such as burning, tingling, and numbness, are referred to as

paresthesias

focal seizure

partial seizure seizure in only one limb or body part

A client has had surgical repair of a hip injury after joint manipulation was unsuccessful. After surgery, the nurse implements measures to prevent complications. Which complications is the nurse seeking to prevent? Select all that apply.

pneumonia, wound infection, skin breakdown, contractures, urinary retention,

Osteoarthritis

progressive degeneration of cartilage in a joint excessive wear and tear on cartilage cause a release of irritative enzymes enzymes erode the cartilage, causing localized inflammation, bone spurs, and limited mobility.

Parkinson's disease

progressive neurodegenerative disease causing muscle rigidity, akinesia, and involuntary tremor -decrease dopamine and increase acetylcholine at the synapse -clinical symptoms occur when dopamine is less than 80< -tremor, rigidity, akinesia, and postural instability

parkinsons disease

progressive neurodegenerative disease causing muscle rigidity, akinesia, and involuntary tremor decreased dopamine and increased acetylcholine at the synapse

status epilepticus

prolonged seizure greater than 5 mins or fails to regain consciousness in between seizures may cause brain damage if not treated

A client has just undergone arthrography. What is the most important instruction for the nurse to include in the teaching plan?

report cracking or clicking noises that occur after the second day

what kind of precautions are used for meningitis?

respiratory and droplet

pelvic fractures

rf: falls, osteoporosis, paget's disease, long term steroid use, bone cancer, substance abuse pain, edema, ecchymosis, muscle spasms.

Nursing students are reviewing information about Parkinson's disease in preparation for class the next day. The students demonstrate understanding of the material when they identify which of the following as a cardinal sign of this disorder? Select all that apply.

rigidity, bradykinesia, tremor, postural instability

Which is a modifiable risk factor for transient ischemic attacks and ischemic strokes?

smoking

examples of closed reduction and external fixation techniques

splint, cast, traction

compartment syndrome

ss: pain, pallor, paresthesia, paralysis, pulselessness avoid use of cold, keep limb at heart level. open or bi-valve cast, to relieve the pressure.

myoclonic seizure

sudden jerk of the body or extremities

CVA

sudden loss of function related to a disruption of blood supply to a part of the brain.

nursing management for stroke

supplemental o2 if below 95% Elevation HOB 30 degrees to assist the patient in handling oral secretions and decrease ICP hemicraniectomy for increased ICP from brain edema in a very large stroke Intubation- endotracheal tube to establish a patent airway, if necessary Continuous hemodynamic monitoring Frequent neurologic assessments

treatments for hemorrhagic stroke

surgical evacuation via craniotomy clip the aneursym

only definite treatment for hemorrhagic stroke

surgical repair via craniotomy

arthoplasty

surgical replacement of a diseased joint used for congential defects, trauma, RA, OA adminsiter Epo alfa, autologus blood donation.

RA patient teaching

take a shower to avoid morning stiffness, physical activity to preserve ROM, use assistive devices

What should the nurse first focus the assessment of a fx extremity on?

the area distal to the fracture

The Monro-Kellie hypothesis explains

the dynamic equilibrium of intracranial contents

bucks traction

used for hip fractures in adults

how should you handle plaster casts?

using your palms not your finger tips until the cast is dry elevate the cast above the level of the heart to decrease swelling.

A patient falls while skiing and sustains a supracondylar fracture. What does the nurse know is the most serious complication of a supracondylar fracture of the humerus?

volkmanns ischdmic contracture

The nurse is providing information about strokes to a community group. Which of the following would the nurse identify as the primary initial symptoms of an ischemic stroke?

weakness on one side of the body and difficulty speaking

a patient with expressive aphasia should consider

writing as a means of communication sound out letters of the alphabet