Ch 67 & 68 Neuro

If warfarin is contraindicated as a treatment for stroke, which medication is the best option?

Aspirin

For a patient with an SCI, why is it beneficial to administer oxygen to maintain a high partial pressure of oxygen (PaO2)?

Because hypoxemia can create or worsen a neurologic deficit of the spinal cord

While making your initial rounds after coming on shift, you find a client thrashing about in bed complaining of a severe headache. The client tells you the pain is behind his right eye which is red and tearing. What type of headache would you suspect this client of having?

Cluster

A patient brought to the hospital after a skiing accident was unconscious for a brief period of time at the scene, then woke up disoriented and refused to go to the hospital for treatment. The patient became very agitated and restless, then quickly lost consciousness again. What type of TBI is suspected in this situation?

Epidural hematoma (Epidural hematomas are often characterized by a brief loss of consciousness followed by a lucid interval in which the patient is awake and conversant. The patient then becomes increasingly restless, agitated, and confused as the condition progresses to coma.)

Which term refers to the shifting of brain tissue from an area of high pressure to an area of low pressure?

Herniation

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 (The student nurse shouldn't keep the client in one position. She should carefully reposition the client often (at least every hour))

A patient is brought to the emergency department with a possible stroke. What initial diagnostic test for a stroke, usually performed in the emergency department, would the nurse prepare the patient for?

Noncontrast computed tomogram (The initial diagnostic test for a stroke is usually a noncontrast computed tomography (CT) scan. This should be performed within 25 minutes or less from the time the patient presents to the emergency department (ED) to determine if the event is ischemic or hemorrhagic (the category of stroke determines treatment).)

early signs of a hemorrhagic stroke

Severe headache, vomiting, early change in level of consciousness, and seizures

When should the nurse plan the rehabilitation of a patient who is having an ischemic stroke?

The day the patient has the stroke

Autoregulation

ability of cerebral blood vessels to dilate or constrict to maintain stable cerebral blood flow despite changes in systemic arterial blood pressure

A client has experienced an ischemic stroke that has damaged the temporal (lateral and superior portions) lobe. Which of the following deficits would the nurse expect during assessment of this client?

auditory agnosia

The three cardinal signs of brain death

coma, the absence of brain stem reflexes, and apnea

Perseveration

continued and automatic repetition of an activity or word or phrase that is no longer appropriate

Verbal apraxia

difficulty forming and organizing intelligible words although the musculature is intact

Agraphia

disturbances in writing intelligible words

Agnosia

failure to recognize familiar objects perceived by the senses

If damage has occurred to the frontal lobe...

learning capacity, memory, or other higher cortical intellectual functions may be impaired. Such dysfunction may be reflected in a limited attention span, difficulties in comprehension, forgetfulness, and lack of motivation.

Which are characteristics of autonomic dysreflexia?

severe hypertension, slow heart rate, pounding headache, sweating

Cushing's response

the brain's attempt to restore blood flow by increasing arterial pressure to overcome the increased ICP

Monro-Kellie hypothesis

Theory that states that, due to limited space for expansion within the skull, an increase in any one of the cranial contents causes a change in the volume of the others.

The nurse is admitting a client from the emergency department with a reported spinal cord injury. What device would the nurse expect to be used to provide correct vertebral alignment and to increase the space between the vertebrae in a client with spinal cord injury?

Traction with weights and pulleys

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 with speech

When communicating with a client who has sensory (receptive) aphasia, the nurse should:

use short, simple sentences. (Although sensory aphasia allows the client to hear words, it impairs the ability to comprehend their meaning. The nurse should use short, simple sentences to promote comprehension.)

Damage to the occipital lobe can result in

visual agnosia