Chapter 37 Disorders of Brain Function
The emergency room doctor suspects a client may have bacterial meningitis. The most important diagnostic test to perform would be:
lumbar puncture
A patient is having difficulty with sleeping and has also been experiencing marital difficulties over the past couple of months. The patient tells the nurse at the physician's office that all this started after he had a car accident earlier that year. Which of the following would be the most important question for the nurse to ask?
"Did you sustain any injuries in the accident?" Postconcussion syndrome can interfere with daily living and also with relationships and can continue for months. The syndrome can include amnesia, insomnia, headache, difficulty concentrating, and irritability. In this situation, it would be very important to determine if the patient sustained a head injury to rule out postconcussion syndrome.
Global and focal brain injuries manifest differently. What is almost always a manifestation of a global brain injury?
Altered LOC
A child is being seen in the emergency department (ED) after ingesting crayons with lead in them. He is disoriented and having seizures. The provider suspects he has which of the following?
Encephalitis Less frequent causes of encephalitis include ingesting toxic substances such as lead. -People experience neurologic disturbances such as lethergy, disorientation, seizures, focal paralysis, delirium and coma. - Bacterial and viral meningitis are caused by bacterial and viral infections. -Meningiomas are a type of brain tumor that are seen in the middle or later years of life.
An adult client has been admitted to a rehabilitation center after hospital treatment for an ischemic stroke. Which aspect of the client's history would be considered to have contributed to his stroke?
The client's blood pressure has historically been in the range of 150s/90s.
A patient suffering a thrombotic stroke is brought into the emergency department by ambulance and the health care team is preparing to administer a synthetic tissue plasminogen activator for which of the following purposes?
Thrombolysis Synthetic tissue plasminogen activators work with the body's natural tissue plasminogen activators to convert plasminogen to plasmin, which breaks down clots to allow for the reestablishment of blood flow. There are two causes of strokes: hemorrhagic and thrombotic, with thrombotic strokes occurring much more frequently. Thrombolytics play a large role in increased outcomes seen with thrombotic strokes.
A client begins to exhibit signs and symptoms of a stroke at a community health fair. Emergency care for the client includes:
going to the nearest stroke center. Salvaging brain tissue, preventing secondary stroke, and minimizing long-term disability are the treatment goals for an acute ischemic stroke. The care of patients with stroke has shifted away from the "nearest hospital" to certified stroke centers. These are hospitals that have been certified by some external agency, most commonly the state or Joint Commission on Accreditation of Healthcare Organizations, the federal agency overseeing all facilities that care for Medicare patients.
The nurse taking a report on a client coming into the emergency room plans care for a client with brain dysfunction based on which of the following symptoms?
stupor
A client is brought to the emergency department and is diagnosed with an ischemic stroke confirmed by CT scan. The most important treatment for this client would be to:
tPA administration is the treatment of choice for an ischemic stroke after confirmation that it is not a hemorrhagic stroke. Monitor vital signs and provide pain relief to prevent complications
T/F: Global or diffuse brain injury is manifested by changes in the level of consciousness.
true: Global brain injury nearly always results in altered levels of consciousness, ranging from inattention to stupor or coma