Exam 3 Medsurg: CVA etc
The pathophysiology of an ischemic stroke involves the ischemic cascade, which includes the following steps: 1. Change in pH 2. Blood flow decreases 3. A switch to anaerobic respiration <wbr /> 4. Membrane pumps fail 5. Cells cease to function 6. Lactic acid is generated Put these steps in order in which they occur.
2. Blood flow decreases 3. A switch to anaerobic respiration <wbr /> 6. Lactic acid is generated 1. Change in pH 4. Membrane pumps fail 5. Cells cease to function
A client has experienced a transient ischemic attack (TIA) and presents with carotid bruits. Which is the priority action to be taken by the nurse, following a bilateral carotid endarterectomy?
Anticipate need for endotracheal intubation.
If warfarin is contraindicated as a treatment for stroke, which medication is the best option?
Aspirin
A client with a new diagnosis of ischemic stroke is deemed to be a candidate for treatment with tissue plasminogen activator (t-PA) and has been admitted to the ICU. In addition to closely monitoring the client's cardiac and neurologic status, the nurse monitors the client for signs of what complication?
Bleeding
subarachnoid hemorrhage
Bleeding into the subarachnoid space, where the cerebrospinal fluid circulates.
What drug, when injected intramuscularly into wrist and finger muscles, has been shown to be effective in reducing this spasticity?
Botulinum toxin type A
A patient who has had a previous stroke and is taking warfarin tells the nurse that he started taking garlic to help reduce his blood pressure. The nurse knows that garlic when taken together with warfarin will produce which type of interaction?
Can greatly increase the international normalization ratio (INR), increasing the risk of bleeding
A client has been diagnosed as having global aphasia. The nurse recognizes that the client will be unable to perform which action?
Form words that are understandable or comprehend spoken words
After a subarachnoid hemorrhage, the client's laboratory results indicate a serum sodium level of less than 126 mEq/L. What is the nurse's most appropriate action?
The client may be experiencing syndrome of inappropriate antidiuretic hormone (SIADH) or cerebral salt-wasting syndrome. The treatment most often is the use of IV hypertonic 3% saline
What can indicate a progression of symptoms or evolving CVA?
drooling and facial drooping
thrombolytic therapy for ischemic strokes has a treatment window of
3 hours
An emergency department (ED) nurse has administered an ordered bolus of tissue plasminogen activator (tPA) to a male patient who was diagnosed with stroke. During the administration of tPA, the nurse should prioritize assessments related to what problem?
Hemorrhage
When communicating with a client who has sensory (receptive) aphasia, the nurse should:
Sensory aphasia makes it difficult for the patient to understand what is being said, using short, simple sentences will promote comprehension
A nurse is reading a journal article about stroke and the underlying causes associated with this condition. The nurse demonstrates understanding of the information when identifying which subtype of stroke as being due to atrial fibrillation?
cardio embolic
