Exam 39: Coordinating Care for Critically Ill Patients With Neurological Dysfunction

A patient with an ischemic stroke is being considered for recombinant tissue plasminogen activator (rt-PA). The nurse recognizes which factors as contraindications to this treatment? Select all that apply.

A patient who suffered a thrombotic stroke has residual left lower extremity motor deficit and dysphagia. The nurse identifies which of the following as the priority nursing diagnosis?

A patient with neurogenic shock has a sustained heart rate of 38 beats per minute. Based on this observation, for what should the nurse prepare the patient?

A patient with a traumatic brain injury is leaking clear fluid from the nose. What action should the nurse take?

A patient with increased intracranial pressure (ICP) is sensitive to fluid-volume shifts. The nurse recognizes which approach as safest to reduce this patient's cerebral edema?

A patient has an intracranial pressure measurement of 22 mm Hg and blood pressure of 174/88 mm Hg. What is the patient's cerebral perfusion pressure?

The nurse is monitoring a patient who is receiving triple H therapy for vasospasm secondary to a subarachnoid hemorrhage. Which finding requires the nurse to immediately contact the healthcare provider?

The nurse monitors for which clinical manifestation in the patient with neurogenic shock?

The nurse is caring for a patient with hypotension caused by neurogenic shock. What action should the nurse take to reduce the risk of developing orthostatic hypotension?

In monitoring a patient with increased intracranial pressure (ICP) who is mechanically ventilated, the nurse correlates which arterial blood gas value to effective management of the increased ICP?

The nurse monitors for which clinical manifestations in the patient experiencing an ischemic stroke of the basilar artery? Select all that apply.

The nurse is caring for a patient admitted for treatment of a subarachnoid hemorrhage caused by a cerebral aneurysm who has a wide neck and tortuous vascular anatomy. The patient is hemodynamically stable with Glasgow Coma Scale of 14. Based on this data, the patient is most likely to have which procedure?

A patient with a cerebral vasospasm is receiving triple H therapy. What parameter should the nurse use to determine adequacy of hemodilution?

In monitoring a trauma patient for shock, the nurse differentiates neurogenic shock from hypovolemic shock by correlating which parameters to neurogenic shock?

The nurse is preparing a patient for insertion of an intraventricular catheter intracranial pressure (ICP) monitoring device. What is an advantage of this device?

The nurse recognizes that which disease process places the patient at the greatest risk for neurogenic shock?

A patient is demonstrating signs of increasing intracranial pressure (ICP). Which nursing actions are indicated to decrease ICP? Select all that apply.

A patient recovering from an ischemic stroke is prescribed verapamil (Calan). The nurse teaches the patient that this medication works by which action?

A patient is admitted with a stroke/brain attack. The nurse correlates which predisposing factor in the patient's history places as placing this patient at greatest risk for embolic stroke?

A patient with neurogenic shock is demonstrating vagal stimulation. What should the nurse expect to be prescribed for this patient?