Podcast
Questions and Answers
Which of the following is the most common type of stroke?
Which of the following is the most common type of stroke?
- Intracerebral hemorrhage
- Ischemic stroke (correct)
- Hemorrhagic stroke
- Subarachnoid hemorrhage
What is the primary cause of an embolic stroke?
What is the primary cause of an embolic stroke?
- Atrial fibrillation (correct)
- Hyperlipidemia
- Atherosclerosis
- Hypertension
Which modifiable risk factor contributes the most to stroke incidence?
Which modifiable risk factor contributes the most to stroke incidence?
- Age
- Male gender
- Family history
- Hypertension (correct)
Which of the following best defines a transient ischemic attack (TIA)?
Which of the following best defines a transient ischemic attack (TIA)?
What does the term "penumbra" refer to in an ischemic stroke?
What does the term "penumbra" refer to in an ischemic stroke?
A patient arrives at the emergency department with sudden right-sided weakness and slurred speech. What is the priority action?
A patient arrives at the emergency department with sudden right-sided weakness and slurred speech. What is the priority action?
A patient with an ischemic stroke is eligible for tissue plasminogen activator (tPA). What is the time window for administration?
A patient with an ischemic stroke is eligible for tissue plasminogen activator (tPA). What is the time window for administration?
Which of the following are priority nursing interventions for a patient with an acute ischemic stroke? (Select all that apply.)
Which of the following are priority nursing interventions for a patient with an acute ischemic stroke? (Select all that apply.)
Which signs and symptoms suggest a left-sided stroke? (Select all that apply.)
Which signs and symptoms suggest a left-sided stroke? (Select all that apply.)
A patient with a hemorrhagic stroke is being monitored for complications. Which findings indicate worsening cerebral edema? (Select all that apply.)
A patient with a hemorrhagic stroke is being monitored for complications. Which findings indicate worsening cerebral edema? (Select all that apply.)
The nurse is caring for a patient who is receiving thrombolytic therapy for an ischemic stroke. Which assessment finding requires immediate intervention?
The nurse is caring for a patient who is receiving thrombolytic therapy for an ischemic stroke. Which assessment finding requires immediate intervention?
Which factor is most important to assess before administering alteplase (tPA) for an ischemic stroke?
Which factor is most important to assess before administering alteplase (tPA) for an ischemic stroke?
A patient recovering from a stroke has difficulty swallowing. Which intervention is most appropriate?
A patient recovering from a stroke has difficulty swallowing. Which intervention is most appropriate?
A patient with right-sided hemiplegia and expressive aphasia is being discharged. Which intervention is appropriate for communication?
A patient with right-sided hemiplegia and expressive aphasia is being discharged. Which intervention is appropriate for communication?
A patient with a history of atrial fibrillation asks how to prevent future strokes. Which response by the nurse is most appropriate?
A patient with a history of atrial fibrillation asks how to prevent future strokes. Which response by the nurse is most appropriate?
A patient is being evaluated for a possible stroke. Which assessment finding suggests a left middle cerebral artery stroke? (Select all that apply.)
A patient is being evaluated for a possible stroke. Which assessment finding suggests a left middle cerebral artery stroke? (Select all that apply.)
Which laboratory values should the nurse review before administering alteplase (tPA)? (Select all that apply.)
Which laboratory values should the nurse review before administering alteplase (tPA)? (Select all that apply.)
The nurse is monitoring a patient with a suspected subarachnoid hemorrhage. Which findings are concerning? (Select all that apply.)
The nurse is monitoring a patient with a suspected subarachnoid hemorrhage. Which findings are concerning? (Select all that apply.)
Which interventions should the nurse prioritize for a patient with increased intracranial pressure (ICP) following a hemorrhagic stroke? (Select all that apply.)
Which interventions should the nurse prioritize for a patient with increased intracranial pressure (ICP) following a hemorrhagic stroke? (Select all that apply.)
The nurse is teaching a patient with modifiable stroke risk factors. Which lifestyle modifications should be emphasized? (Select all that apply.)
The nurse is teaching a patient with modifiable stroke risk factors. Which lifestyle modifications should be emphasized? (Select all that apply.)
A patient with a stroke is experiencing unilateral neglect. Which nursing intervention is most effective?
A patient with a stroke is experiencing unilateral neglect. Which nursing intervention is most effective?
A patient receiving warfarin therapy for stroke prevention has an INR of 5.2. What is the priority action?
A patient receiving warfarin therapy for stroke prevention has an INR of 5.2. What is the priority action?
A patient with a stroke develops pneumonia. Which factor most likely contributed?
A patient with a stroke develops pneumonia. Which factor most likely contributed?
A patient with a stroke has been placed on aspiration precautions. Which intervention should be included?
A patient with a stroke has been placed on aspiration precautions. Which intervention should be included?
Which of the following are common complications of stroke rehabilitation? (Select all that apply.)
Which of the following are common complications of stroke rehabilitation? (Select all that apply.)
The nurse is educating a patient on stroke prevention. Which dietary modifications should be recommended? (Select all that apply.)
The nurse is educating a patient on stroke prevention. Which dietary modifications should be recommended? (Select all that apply.)
A patient with a history of transient ischemic attacks (TIAs) is prescribed clopidogrel (Plavix). What is the primary purpose of this medication?
A patient with a history of transient ischemic attacks (TIAs) is prescribed clopidogrel (Plavix). What is the primary purpose of this medication?
The nurse is assessing a patient with an ischemic stroke in the emergency department. The patient suddenly develops a severe headache, nausea, and a decline in level of consciousness. What is the nurse's priority action?
The nurse is assessing a patient with an ischemic stroke in the emergency department. The patient suddenly develops a severe headache, nausea, and a decline in level of consciousness. What is the nurse's priority action?
A patient with a history of stroke is being discharged on warfarin. Which patient statement indicates the need for further teaching?
A patient with a history of stroke is being discharged on warfarin. Which patient statement indicates the need for further teaching?
Which nursing intervention is most appropriate for a patient with right-sided hemiparesis?
Which nursing intervention is most appropriate for a patient with right-sided hemiparesis?
The nurse is assessing a stroke patient. Which signs suggest dysphagia? (Select all that apply.)
The nurse is assessing a stroke patient. Which signs suggest dysphagia? (Select all that apply.)
A patient with a left-sided stroke has difficulty understanding speech but can speak fluently. What is the most likely diagnosis?
A patient with a left-sided stroke has difficulty understanding speech but can speak fluently. What is the most likely diagnosis?
A patient with an acute ischemic stroke is prescribed IV labetalol. What is the purpose of this medication?
A patient with an acute ischemic stroke is prescribed IV labetalol. What is the purpose of this medication?
Which factors increase a patient's risk of hemorrhagic stroke? (Select all that apply.)
Which factors increase a patient's risk of hemorrhagic stroke? (Select all that apply.)
A stroke patient is experiencing emotional lability. What intervention is most appropriate?
A stroke patient is experiencing emotional lability. What intervention is most appropriate?
A patient with a stroke is experiencing incontinence. What interventions can help? (Select all that apply.)
A patient with a stroke is experiencing incontinence. What interventions can help? (Select all that apply.)
A patient receiving tPA therapy develops bleeding from the IV site. What is the nurse's priority action?
A patient receiving tPA therapy develops bleeding from the IV site. What is the nurse's priority action?
Which goal is most appropriate for a patient in the acute phase of a stroke?
Which goal is most appropriate for a patient in the acute phase of a stroke?
A patient with left-sided neglect is at risk for injury. What intervention can help?
A patient with left-sided neglect is at risk for injury. What intervention can help?
The nurse is evaluating a stroke patient's rehabilitation progress. Which outcome suggests improvement?
The nurse is evaluating a stroke patient's rehabilitation progress. Which outcome suggests improvement?
A patient who had a stroke 6 months ago reports depression. What is the best nursing intervention?
A patient who had a stroke 6 months ago reports depression. What is the best nursing intervention?
A patient with a history of TIAs asks how to reduce stroke risk. What is the best response?
A patient with a history of TIAs asks how to reduce stroke risk. What is the best response?
A patient is in a rehabilitation unit after a stroke and expresses frustration about their slow progress in regaining mobility. What is the most appropriate nursing response?
A patient is in a rehabilitation unit after a stroke and expresses frustration about their slow progress in regaining mobility. What is the most appropriate nursing response?
The nurse is teaching a patient and family about post-stroke home safety. Which recommendations should be included? (Select all that apply.)
The nurse is teaching a patient and family about post-stroke home safety. Which recommendations should be included? (Select all that apply.)
The nurse is planning discharge teaching for a patient who had a stroke and now has hemiparesis. Which statement by the patient indicates a need for further education?
The nurse is planning discharge teaching for a patient who had a stroke and now has hemiparesis. Which statement by the patient indicates a need for further education?
Flashcards
Ischemic Stroke Cause
Ischemic Stroke Cause
An ischemic stroke occurs due to a blockage in a cerebral artery, often from a thrombus or embolus.
Embolic Stroke Cause
Embolic Stroke Cause
Atrial fibrillation can cause blood to pool in the atria, potentially leading to clot formation and embolic stroke.
Stroke Risk Factor
Stroke Risk Factor
Hypertension is the most significant modifiable risk factor, increasing the risk for both ischemic and hemorrhagic strokes.
Transient Ischemic Attack
Transient Ischemic Attack
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Ischemic Stroke Penumbra
Ischemic Stroke Penumbra
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tPA Administration
tPA Administration
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Worsening Cerebral Edema
Worsening Cerebral Edema
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tPA Time Window
tPA Time Window
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Expressive Aphasia
Expressive Aphasia
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Left MCA Stroke Effects
Left MCA Stroke Effects
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Labs Before tPA
Labs Before tPA
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Subarachnoid Hemorrhage
Subarachnoid Hemorrhage
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Increased ICP Interventions
Increased ICP Interventions
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Unilateral Neglect
Unilateral Neglect
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High INR Action
High INR Action
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Stroke Pneumonia Risk
Stroke Pneumonia Risk
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Stroke Rehab Complications
Stroke Rehab Complications
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Clopidogrel Use
Clopidogrel Use
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Warfarin Diet
Warfarin Diet
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Acute Stroke BP
Acute Stroke BP
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Study Notes
- Ischemic stroke is the most common type, accounting for about 87% of all strokes.
- Ischemic strokes result from a blockage in a cerebral artery, usually by a thrombus or embolus.
- Atrial fibrillation increases the risk for blood to pool in the atria, which can lead to clot formation, causing an embolic stroke if the clot dislodges and travels to the brain.
- Hypertension is the most significant modifiable risk factor for strokes.
- Hypertension increases the risk of both ischemic and hemorrhagic strokes.
- A transient ischemic attack (TIA) involves a brief episode of neurological dysfunction caused by ischemia, resolving within 24 hours without permanent damage.
- Penumbra refers to the area of reversible ischemia surrounding the infarct in an ischemic stroke, salvageable with timely reperfusion therapy.
- A non-contrast CT scan is the priority action for a patient arriving in the emergency department with sudden right-sided weakness and slurred speech.
- CT scans can differentiate between ischemic and hemorrhagic strokes, guiding appropriate treatment.
- Tissue plasminogen activator (tPA) is most effective when administered within 3 to 4.5 hours of symptom onset for ischemic stroke.
- tPA helps dissolve the clot and restore blood flow.
- Priority nursing interventions for an acute ischemic stroke include closely monitoring blood pressure, assessing for signs of increased intracranial pressure (ICP), and keeping the patient NPO until a swallowing evaluation.
- Right-sided hemiparesis, aphasia, and slow, cautious movements suggest a left-sided stroke.
- Decreased level of consciousness, widened pulse pressure, bradycardia, and irregular respirations are findings that indicate worsening cerebral edema in the case of a hemorrhagic stroke.
- A sudden decrease in consciousness is a finding that requires immediate intervention for a patient receiving thrombolytic therapy for an ischemic stroke.
- Reduced level of consciousness may indicate hemorrhagic transformation, a complication of thrombolytic therapy.
- The time of symptom onset is the most important factor to assess before administering alteplase (tPA) for an ischemic stroke.
- tPA must be given within 3 to 4.5 hours of symptom onset for effectiveness and safety.
- The chin-tuck maneuver helps prevent aspiration by directing food away from the airway for a patient recovering from a stroke with difficulty swallowing.
- Nursing interventions for a patient with right-sided hemiplegia and expressive aphasia include using short, simple sentences and gestures.
- Strokes stemming from atrial fibrillation increase stroke risk due to clot formation, so anticoagulation therapy (e.g., warfarin, DOACs) is recommended.
- A left middle cerebral artery (MCA) stroke can be suggested by findings such as right-sided hemiparesis, dysphagia, and expressive aphasia.
- Prior to administering alteplase (tPA), the nurse should review laboratory values for platelet count, INR, and blood glucose.
- A subarachnoid hemorrhage (SAH) presents with a sudden, severe "thunderclap" headache, stiff neck (meningismus), photophobia, and potential loss of consciousness.
- Nursing interventions to prioritize for a patient with increased intracranial pressure (ICP) following a hemorrhagic stroke include elevating the head of the bed to 30 degrees, administering IV mannitol, and maintaining a quiet, dimly lit environment.
- Key lifestyle modifications to emphasize for a patient with modifiable stroke risk factors include controlling hypertension, managing diabetes, reducing salt intake, and stopping smoking.
- Encouraging the patient to scan the affected side is the most effective nursing intervention for unilateral neglect.
- For a patient receiving warfarin therapy for stroke prevention with an INR of 5.2, the priority action is to administer vitamin K.
- An INR above the therapeutic range increases bleeding risk, and vitamin K reverses warfarin effects.
- Decreased level of consciousness is the factor that increases risks associated with developing pneumonia in a stroke patient.
- Patients with a decreased level of consciousness impairs airway protection, leading to aspiration pneumonia.
- Patients should be NPO after a stroke until a swallow evaluation to prevent aspiration-related complications.
- Common complications of stroke rehabilitation include contractures, depression, urinary incontinence, and chronic pain.
- A diet high in whole grains, fruits, and vegetables while reducing processed foods can help lower stroke risk by controlling hypertension and cholesterol.
- Clopidogrel (Plavix) is prescribed to prevent platelet aggregation.
- Sudden development of severe headache, nausea, and a decline in level of consciousness for a patient being assessed would require a nurse to immediately notify the healthcare provider.
- A patient statement indicating the need for further teaching when being discharged on warfarin is "I should eat green leafy vegetables daily to improve my diet."
- Green leafy vegetables contain vitamin K, which can interfere with warfarin's anticoagulant effects.
- Patients with right-sided hemiparesis should be encouraged to dress the affected side first.
- Nursing interventions appropriate for dysphagia include coughing while eating, drooling, and pocketing food in the cheek.
- Wernicke's aphasia is charactarized by difficulty in speech understanding while speech remains fluent.
- IV labetalol is prescribed for an acute ischemic stroke to lower blood pressure safely.
- The controlled BP reduction helps prevent further brain damage.
- Key risk factors for hemorrhagic stroke included chronic hypertension, aneurysm rupture, and anticoagulant use.
- Educating the family on emotional changes is the most appropriate intervention for a stroke patient experiencing emotional lability.
- Appropriate interventions that can help with incontinence after a stroke include establishing a toileting schedule, encouraging Kegel exercises, and monitoring for signs of urinary tract infection.
- If a patient receiving tPA therapy develops bleeding from the IV site, apply direct pressure to the site.
- Applying pressure is the nurse's priority action.
- The most appropriate goal for a patient in the acute phase of a stroke is to prevent complications and stabilize the patient.
- Approach patients with left-sided neglect from the unaffected side.
- Improved ability to swallow indicates improvement in a stroke patient's rehabilitation progress.
- Social support can improve post-stroke depression, so you should encourage social interaction.
- Adherence to medication reduces stroke risk.
- Acknowledging the patient's emotions and promoting goal-setting fosters motivation and enhances rehabilitation outcomes.
- Fall prevention is critical for stroke patients, therefore home modifications (e.g., removing hazards, installing grab bars, and ensuring good lighting) enhance safety.
- Patients should be prescribed physical therapy because it is crucial for regaining strength, coordination, and independence after a stroke.
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