Questions and Answers
The nurse should teach the family that these responses are typically a result of what cause? (Select all that apply)
What would be the nurse's best answer to the family's question about the patient's self-care after a stroke?
What complication should the nurse monitor for in a patient with a new diagnosis of ischemic stroke receiving t-PA treatment?
What action should the nurse perform to best prevent joint deformities in a patient with an ischemic stroke?
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For what purpose is a carotid endarterectomy performed in a patient diagnosed with transient ischemic attacks (TIAs)?
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What common response to a change in body image should the nurse be aware of when discharging a patient who suffered a stroke?
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What is the earliest sign of deterioration in a patient with a hemorrhagic stroke?
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Which patient is likely at the highest risk for a hemorrhagic stroke?
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On what should the nurse's primary assessment focus for a patient who just suffered a suspected ischemic stroke?
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What nursing intervention would be most appropriate for a patient with a cerebral aneurysm exhibiting signs of increased intracranial pressure (ICP)?
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To prevent further injury and pain from subluxation of the shoulder in a stroke patient, what principle of care should be followed?
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What can the nurse do to best make the atmosphere more conducive to communication for a patient diagnosed with aphasia after a stroke?
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What assessment finding is most suggestive of a stroke?
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Which of the following should be integrated into the care plan for effective positioning of a patient diagnosed with an ischemic stroke?
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What nursing action will the nurse incorporate into the care plan for a patient with specific aneurysm precautions?
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When creating a plan of care for a patient diagnosed with a hemorrhagic stroke, what goal should be prioritized?
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What content should the nurse include in health education for a patient being discharged after hospitalization for a hemorrhagic stroke?
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What action is a priority when a patient diagnosed with a cerebral aneurysm reports a severe headache?
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What is an absolute contraindication for thrombolytic therapy in a patient suspected of having a stroke?
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What patient position is most consistent with the goal of reducing ICP after a stroke?
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When approaching a patient with disturbed sensory perception after an ischemic stroke, on which side should the nurse approach the patient?
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What should be included in a care plan for an exercise program for a patient affected by a stroke?
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How might the nurse help a female patient diagnosed with a right-sided stroke manage hemianopsia?
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What percentage of total strokes in the United States currently accounts for hemorrhagic stroke?
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What principle of care should inform the nurse's response to a patient's family insisting on bed rest to hasten recovery after an ischemic stroke?
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To protect a patient's safety during mobilization after an ischemic stroke, what action should the nurse take?
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What should family education for a patient diagnosed with a hemorrhagic stroke include?
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What action should the nurse take if a patient's serum sodium level is less than 126 mEq/L after a subarachnoid hemorrhage?
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What nonmodifiable risk factor for stroke should the community health nurse cite?
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What is the best advice the nurse could give to a family member to reduce the risk of having another stroke?
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Which medication carries the greatest potential for reducing a woman's risk of stroke?
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What should the nurse do if a patient with a hemorrhagic stroke becomes progressively more drowsy?
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What nursing action should be included in the care plan of a patient on cerebral aneurysm precautions?
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Which cardiac dysrhythmia is associated with cardiogenic embolic strokes?
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Put the steps of the ischemic cascade in order:
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What are the contraindications for thrombolytic therapy? (Select all that apply)
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What should nursing care include during the immediate recovery period from an ischemic stroke?
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What intervention best addresses a potential complication after an ischemic stroke?
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What are the predictors of stroke outcomes? (Select all that apply)
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What major nursing diagnosis should most likely be included in the care plan for a newly admitted patient diagnosed with a stroke?
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Study Notes
Management of Cerebrovascular Disorders
- Proper positioning post-stroke is crucial to prevent joint deformities; placing a pillow in the axilla aids in limiting external rotation.
- Carotid endarterectomy addresses transient ischemic attacks (TIAs) by removing atherosclerotic plaques that obstruct cerebral blood flow.
- Depression is a common psychological response after a stroke, particularly in patients with changes in body image and increased dependency.
- Early detection of deterioration in hemorrhagic stroke patients includes monitoring alterations in the level of consciousness (LOC), which may indicate deterioration.
- Uncontrolled hypertension is a significant risk factor for hemorrhagic stroke particularly notable in older males.
- Primary assessment of a patient with suspected ischemic stroke should focus on cardiac and respiratory status to ensure stability.
Patient Safety and Care Interventions
- Absolute bed rest in a quiet environment is essential for patients with cerebral aneurysms exhibiting increased intracranial pressure (ICP) symptoms.
- Shoulder pain management in stroke recovery includes teaching patients gentle movements to avoid further injury and pain.
- To improve communication for patients with aphasia, providing boards of commonly used phrases can facilitate understanding and interaction.
- Facial droop is a classic sign of stroke that should prompt immediate assessment.
Risk Factors and Preventative Care
- Actively mobilizing stroke patients as soon as feasible is key to reduce the risk of contractures and muscle atrophy.
- Essential education for stroke survivors includes adhering to prescribed antihypertensive medications to prevent recurrence.
- Awareness of potential complications like cerebral edema post-stroke, necessitating positioning strategies to avoid hypoxia, is critical.
- Atrial fibrillation is a significant cardiac dysrhythmia associated with an increased risk of embolic strokes.
Neurologic Assessments and Monitoring
- Continuous monitoring of neurologic status is vital in patients recovering from hemorrhagic strokes due to the risk of progressive deterioration.
- Signs of decreased potassium levels or drowsiness warrant immediate notification of a physician, indicating possible clinical decline.
- Nurses should document and assess the National Institutes of Health Stroke Scale (NIHSS) score, level of consciousness, and patient age as predictors for stroke outcomes.
Community Education and Risk Management
- Nonmodifiable risk factors for stroke include advanced age, and efforts should be focused on lifestyle modifications such as smoking cessation in high-risk individuals.
- Family education should address the need for environmental modifications to ensure safety and minimize risks of falls or injuries post-stroke.
Rehabilitation Considerations
- During rehabilitation, support of self-care strategies enhances patient autonomy, and family members should understand the importance of promoting independence.
- Unexpected emotional responses in stroke patients often stem from frustration with functional changes and should be addressed empathetically.
Medicinal Management
- Aspirin (81 mg) can significantly reduce the risk of stroke for patients with multiple risk factors.
- Monitoring for bleeding complications is vital during tissue plasminogen activator (t-PA) therapy in ischemic stroke patients to prevent serious adverse effects.
Summary of Key Nursing Responses
- Encourage communication and involve patients with aphasia in decision-making through supportive tools.
- Use active teach-back methods for families to enhance understanding of stroke risks and self-management strategies post-discharge.
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Description
This quiz focuses on the management of patients with cerebrovascular disorders, particularly after an ischemic stroke. It will cover nursing interventions aimed at preventing joint deformities and promoting patient mobility. Test your knowledge on critical care strategies in this crucial area of nursing.
