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What should be the primary goal of nursing care for a patient after a stroke once they have stabilized?
What should be the primary goal of nursing care for a patient after a stroke once they have stabilized?
Which of the following is NOT a common nursing goal for a stroke patient?
Which of the following is NOT a common nursing goal for a stroke patient?
During the acute phase after a stroke, which respiratory problem is a patient particularly at risk for?
During the acute phase after a stroke, which respiratory problem is a patient particularly at risk for?
Which of the following measures helps maintain optimal function of the musculoskeletal system in stroke patients?
Which of the following measures helps maintain optimal function of the musculoskeletal system in stroke patients?
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What is the most common bowel problem encountered by stroke patients?
What is the most common bowel problem encountered by stroke patients?
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What is the priority for managing the urinary system in stroke patients?
What is the priority for managing the urinary system in stroke patients?
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In the first 24 hours after a stroke, what should be assessed regarding the patient's swallowing ability?
In the first 24 hours after a stroke, what should be assessed regarding the patient's swallowing ability?
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What is a key role of healthcare professionals to reduce the incidence of stroke?
What is a key role of healthcare professionals to reduce the incidence of stroke?
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What is the primary goal during the acute phase of care for ischemic stroke patients?
What is the primary goal during the acute phase of care for ischemic stroke patients?
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Which of the following is a common treatment for preventing further strokes in patients who have experienced a TIA?
Which of the following is a common treatment for preventing further strokes in patients who have experienced a TIA?
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What is the significance of the time of onset in the evaluation of a patient with ischemic stroke?
What is the significance of the time of onset in the evaluation of a patient with ischemic stroke?
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What surgical interventions may be performed for a patient with TIAs caused by carotid disease?
What surgical interventions may be performed for a patient with TIAs caused by carotid disease?
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During acute care for hemorrhagic stroke, which therapy is used to manage hypertension and prevent seizures?
During acute care for hemorrhagic stroke, which therapy is used to manage hypertension and prevent seizures?
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What is an important aspect of managing fluid and electrolyte balance in stroke patients?
What is an important aspect of managing fluid and electrolyte balance in stroke patients?
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Which diagnostic procedure is necessary to evaluate the presence of intracranial pressure in a stroke patient?
Which diagnostic procedure is necessary to evaluate the presence of intracranial pressure in a stroke patient?
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What is homonymous hemianopsia commonly associated with after a stroke?
What is homonymous hemianopsia commonly associated with after a stroke?
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What type of drug therapy would be administered to reduce the incidence of cerebral vasospasms in hemorrhagic stroke patients?
What type of drug therapy would be administered to reduce the incidence of cerebral vasospasms in hemorrhagic stroke patients?
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What is crucial for maximizing a patient's abilities during stroke rehabilitation?
What is crucial for maximizing a patient's abilities during stroke rehabilitation?
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During the acute phase of stroke recovery, which functions should rehabilitation initially emphasize?
During the acute phase of stroke recovery, which functions should rehabilitation initially emphasize?
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What is a general preventive measure at risk for stroke patients to avoid thrombus or embolus formation?
What is a general preventive measure at risk for stroke patients to avoid thrombus or embolus formation?
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During which phase does treatment shift towards rehabilitation?
During which phase does treatment shift towards rehabilitation?
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What dietary adjustment may be necessary for a stroke patient?
What dietary adjustment may be necessary for a stroke patient?
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What type of deficits might a patient with a stroke on the right side of the brain typically experience?
What type of deficits might a patient with a stroke on the right side of the brain typically experience?
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What is a common emotional challenge faced by stroke patients?
What is a common emotional challenge faced by stroke patients?
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Which risk factor is considered the most significant modifiable risk factor for stroke prevention?
Which risk factor is considered the most significant modifiable risk factor for stroke prevention?
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What is a transient ischemic attack (TIA)?
What is a transient ischemic attack (TIA)?
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Which type of professional is typically involved in assessing and planning care for communication deficits in stroke patients?
Which type of professional is typically involved in assessing and planning care for communication deficits in stroke patients?
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What type of stroke results from inadequate blood flow to the brain due to an occluded artery?
What type of stroke results from inadequate blood flow to the brain due to an occluded artery?
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What aspect of stroke rehabilitation is often highlighted as being mutually set by all team members?
What aspect of stroke rehabilitation is often highlighted as being mutually set by all team members?
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Which of the following statements is true regarding thrombotic strokes?
Which of the following statements is true regarding thrombotic strokes?
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What nursing measure is focused on promoting urinary continence in stroke patients?
What nursing measure is focused on promoting urinary continence in stroke patients?
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Which factor can significantly contribute to the stress experienced by patients during a stroke event?
Which factor can significantly contribute to the stress experienced by patients during a stroke event?
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Which diagnostic study is effective in assessing blood flow to the brain during a suspected stroke?
Which diagnostic study is effective in assessing blood flow to the brain during a suspected stroke?
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What is a common motor deficit that may occur after a stroke?
What is a common motor deficit that may occur after a stroke?
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Which of the following best describes the prognosis for intracerebral hemorrhage?
Which of the following best describes the prognosis for intracerebral hemorrhage?
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Which diagnostic tool is primarily used to distinguish between ischemic and hemorrhagic stroke?
Which diagnostic tool is primarily used to distinguish between ischemic and hemorrhagic stroke?
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What is a key goal of preventive therapy for stroke?
What is a key goal of preventive therapy for stroke?
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Which symptom is NOT commonly associated with motor deficits after a stroke?
Which symptom is NOT commonly associated with motor deficits after a stroke?
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What characterizes subarachnoid hemorrhage?
What characterizes subarachnoid hemorrhage?
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Which of the following statements regarding a right-sided stroke is true?
Which of the following statements regarding a right-sided stroke is true?
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What should be assessed to confirm a diagnosis of stroke?
What should be assessed to confirm a diagnosis of stroke?
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What emotional change might a patient experience after a stroke?
What emotional change might a patient experience after a stroke?
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Which of the following is typically NOT a cause of subarachnoid hemorrhage?
Which of the following is typically NOT a cause of subarachnoid hemorrhage?
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Nursing interventions for stroke patients do not include monitoring the respiratory system as it is not a priority.
Nursing interventions for stroke patients do not include monitoring the respiratory system as it is not a priority.
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Nursing goals for stroke patients include maintaining a stable level of consciousness and maximizing communication abilities.
Nursing goals for stroke patients include maintaining a stable level of consciousness and maximizing communication abilities.
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Administering IV infusions to stroke patients is only done to provide medications and has no role in maintaining fluid and electrolyte balance.
Administering IV infusions to stroke patients is only done to provide medications and has no role in maintaining fluid and electrolyte balance.
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Nurses are responsible for assessing swallowing ability within the first 48 hours after a stroke.
Nurses are responsible for assessing swallowing ability within the first 48 hours after a stroke.
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Promoting normal bladder function in stroke patients can include avoiding the use of indwelling catheters.
Promoting normal bladder function in stroke patients can include avoiding the use of indwelling catheters.
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Antiplatelet drugs are used to prevent thrombus or embolus formation in patients at risk for stroke.
Antiplatelet drugs are used to prevent thrombus or embolus formation in patients at risk for stroke.
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Managing airway, breathing, circulation, and intracranial pressure is only crucial in patients who have experienced a hemorrhagic stroke.
Managing airway, breathing, circulation, and intracranial pressure is only crucial in patients who have experienced a hemorrhagic stroke.
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Platelet inhibitors and anticoagulants are given to stabilize patients after they have had a stroke.
Platelet inhibitors and anticoagulants are given to stabilize patients after they have had a stroke.
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A nurse should prioritize monitoring for increasing neurological deficits in patients who have had an ischemic stroke.
A nurse should prioritize monitoring for increasing neurological deficits in patients who have had an ischemic stroke.
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Recombinant tissue plasminogen activator (tPA) must be administrated within 6 hours of stroke onset.
Recombinant tissue plasminogen activator (tPA) must be administrated within 6 hours of stroke onset.
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Fluid and electrolyte balance is less important during the acute care of stroke patients.
Fluid and electrolyte balance is less important during the acute care of stroke patients.
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Surgical interventions are only considered for patients with ischemic strokes, not for hemorrhagic strokes.
Surgical interventions are only considered for patients with ischemic strokes, not for hemorrhagic strokes.
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Elevated blood pressure after a stroke is always harmful and should be treated immediately.
Elevated blood pressure after a stroke is always harmful and should be treated immediately.
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Careful control of fluid balance in stroke patients can help decrease the likelihood of subsequent brain injury.
Careful control of fluid balance in stroke patients can help decrease the likelihood of subsequent brain injury.
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The selection of surgical procedures for hemorrhagic strokes is based solely on the patient's age.
The selection of surgical procedures for hemorrhagic strokes is based solely on the patient's age.
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Study Notes
Stroke Pathophysiology
- The brain needs a constant blood supply of oxygen and glucose for neurons to function.
- A stroke occurs when the blood supply to the brain is interrupted, either due to ischemia (reduced blood flow) or hemorrhage (bleeding).
- Interruption of blood supply results in brain cell death.
- Two major artery pairs supply blood to the brain: internal carotid arteries (anterior circulation) and vertebral arteries (posterior circulation).
- Factors affecting blood flow include systemic blood pressure, cardiac output, and blood viscosity.
- Atherosclerosis (hardening and thickening of arteries) is a primary cause of ischemic stroke. It leads to thrombus formation and emboli.
Stroke Risk Factors
- Prevention is the most effective way to reduce stroke burden.
- Non-modifiable risk factors include age, gender, race, and heredity.
- Hypertension is the most important modifiable risk factor.
- Other modifiable risk factors include high serum cholesterol, smoking, excessive alcohol consumption, obesity, physical inactivity, poor diet, cardiac abnormalities, and drug use.
Types of Stroke
Ischemic Stroke
- Transient ischemic attack (TIA): temporary neurological dysfunction caused by reduced blood flow, without permanent brain damage. Symptoms usually last less than an hour.
- Ischemic stroke: inadequate blood flow to a part of the brain, caused by either thrombotic (clot formation in the blood vessel) or embolic (traveling clot) strokes.
- A thrombotic stroke's extent depends on the onset speed, lesion size, and presence of collateral circulation.
- Embolic strokes result in infarction (tissue death) and edema in the affected area, with symptoms often appearing quickly.
Hemorrhagic Stroke
- Hemorrhagic stroke occurs from bleeding into the brain tissue itself or the subarachnoid space or ventricles.
- Bleeding can be caused by a ruptured blood vessel (intracerebral hemorrhage) or blood vessel in the surface of the brain (subarachnoid hemorrhage).
Clinical Manifestations of Stroke
- Stroke manifestations depend on the affected area of the brain.
- Affected areas can involve motor function, bladder/bowel function, cognitive function, spatial perception, personality, sensation, swallowing, and communication.
- Stroke can also cause aphasia, dysphasia, dysphagia, and dysarthria (problems with speech).
- Emotional control and memory/judgment may be affected.
Diagnostic Studies for Stroke
- Diagnostic tests confirm stroke by ruling out other brain conditions (e.g., subdural hematoma).
- MRI and non-contrast CT scans are important diagnostic tools to show the size and location of brain lesions, distinguishing between ischemic and hemorrhagic stroke.
Interprofessional Care for Stroke
Preventive Therapy
- Managing modifiable risk factors (healthy diet, weight control, regular exercise, no smoking, and controlling hypertension) reduces the risk of stroke.
- Antiplatelet drugs are commonly used to prevent further stroke in patients with TIA.
- Surgical interventions might include carotid endarterectomy, transluminal angioplasty, and stenting for patients with carotid disease.
Acute Ischemic Stroke Care
- Goals focus on life preservation, prevention of further brain damage, and reducing disability.
- Initial care involves managing airway, breathing, and circulation (ABC). Monitor blood pressure carefully as it may be a protective response for cerebral perfusion.
- Baseline neurologic assessment, and monitoring for increasing neurological deficits and increased intracranial pressure (ICP) are crucial.
- Fluid and electrolyte balance must be carefully controlled.
- Administer recombinant tissue plasminogen activator (tPA) within 3-4.5 hours of stroke onset.
- Platelet inhibitors and anticoagulants may be given to prevent further clot formation.
Acute Hemorrhagic Stroke Care
- Goals including managing ABC and intracranial pressure, are similar to ischemic stroke care.
Rehabilitative Care for Stroke
- Treatment strategies evolve as the patient progresses from the acute to rehabilitation phase, focusing on lessening disability and achieving optimal function.
- The Joint Commission has established stroke core measures to guide improvements.
- Rehabilitation efforts maximize the patient's functional abilities, focusing on self-care, communication, and coping skills.
- Speech therapists assist with communication issues, and dieticians manage appropriate nutritional intake.
Nursing Management for Stroke
- Comprehensive nursing care promotes stable/improved consciousness, maximal self-care skills, optimal function, and effective coping strategies for the patient and family.
- Focus on preventing complications like deep vein thrombosis (DVT), promoting skin integrity, ensuring adequate nutrition, and addressing communication and perceptual deficits.
- Address bowel and bladder function and potential perceptual problems.
- Implement a bowel management program to address constipation or incontinence and maintain urinary continence.
Ambulatory Care
- Stroke patients transition from acute care to other settings like home or rehab facilities.
- Ongoing rehab maximizes abilities with a team approach encompassing patients, families, and healthcare professionals.
- Rehabilitation goals, including eating, toileting, walking, and progressive activities, are mutually set in collaboration.
- Ongoing assessment for caloric intake and swallowing ability is key.
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Description
This quiz covers the essential aspects of stroke pathophysiology, including the brain's blood supply needs and the consequences of interrupted blood flow. It also delves into the risk factors associated with stroke, distinguishing between modifiable and non-modifiable elements. Test your knowledge on these critical health themes.
