– Complete Exam 2 Study Guide
Introduction:
This document contains a comprehensive overview of key
concepts for NUR 121 Exam 2, covering neurological and
gastrointestinal disorders. Topics include stroke types and
management, traumatic brain injuries, dementia, Parkinson’s
disease, abdominal disorders, inflammatory bowel diseases,
cirrhosis, and related diagnostics, assessments, and
interventions.
The material is structured in a question-and-answer format,
making it ideal for active recall, NCLEX-style preparation, and
focused exam review.
Exam Questions and Answers:
Embolic Stroke -Answer:embolus mainly from heart; seen in
AFib; sudden onset
-Risks: valve heart disease, prosthetic heart valve, or
endocarditis
,Hemorrhagic Stroke -Answer:vessel integrity --> bleeding into
brain
-Goal: find and stop bleed!
Types: ICH, SAH, aneurysm, AVM
Intracerebral hemorrhage (ICH) -Answer:severe, uncontrolled
HTN or long term cocaine use
Subarachnoid Hemorrhage (SAH) -Answer:resulting from
ruptured aneurysm; sudden onset; "worst h/a of my life"
Arteriovenous Malformation (AVM) -Answer:uncommon;
during development of fetus
Teaching Acronym for Patients Who Have Had A Stroke -
Answer:*ABCS*
*A*spirin use when appropriate
*B*P control
*C*holesterol management
*S*moking cessation
Also: DM control, obesity control, ↓ substance use
,Stroke Assessment -Answer:-Hx of anticoags prior, rule out ↓/↑
glycemia/hypoxia/migraine
-Stroke assessment tools: GCS, NIHSS (to qualify for
fibrinolytic therapy)
*dysphagia/aspiration --> NPO
-Emotional Lability: intense emotion (laugh/cry) for no
reason, uncontrollable
Aspiration Risk Factors -Answer:impulsiveness- scarfing down
food (R stroke), size/texture of food, ↓ HOB
How to Feed Pt w/ Dysphagia from Stroke -Answer:min 30min
rest period, HOB 90 during, then 45-90 1hr after; vary
placement of food in mouth (place on side w/ no paralysis) and
make sure food is down; approach on non paralysis side
Stroke Physical Assessment: R Hemisphere -Answer:impulsive,
poor judgment, issues in controlling emotions --> emotional
lability, disorientated X2 (place/time)
-not aware of having these issues --> agitated/anxious
Stroke Physical Assessment: L Hemisphere -Answer:speech,
language, math skills affected
, Expressive (Broca's) Aphasia -Answer:motor; damage to
Broca's region in frontal lobe; able to understand but cannot
speak; able to read, agraphia
Receptive (Wernicke's) Aphasia -Answer:sensory; damage to
Wernicke's region in temporal/parietal lobe; unable to
understand spoken/written words but can speak w/ no
structure
Stroke Diagnostics -Answer:-CBC: ↑ H/H, WBC; glucose/A1C
-PT/INR/PTT: fibrinolytic therapy
-CTA/CTP: definitive of having stroke; how much ischemia is
in brain
Fibrinolytic/Alteplase Therapy -Answer:Needs to be qualified
w/ NIHSS; if qualified, pt can fully recover; need to start w/in
45min upon entering hospital
Duration Qualifying: up to 4 1/2hrs after s/s begin
Fibrinolytic Rule Outs for Stroke Therapy -Answer:80yr>, took
any anticoagulants prior, NIHSS 25> ,