NUR.,2520.,-.,Unit.,II.,-.,Stroke/Seizures
The.,nurse.,in.,a.,primary.,care.,provider's.,office.,is.,assessing.,several.,patients.,
today..,Which.,patient.,is.,most.,at.,risk.,for.,a.,stroke?
a..,A.,92-year-
old.,female.,who.,takes.,warfarin.,(Coumadin).,for.,atrial.,fibrillation.
b..,A.,28-year-
old.,male.,who.,uses.,marijuana.,after.,chemotherapy.,to.,control.,nausea.
c..,A.,42-year-
old.,female.,who.,takes.,oral.,contraceptives.,and.,has.,migraine.,headaches.
d..,A.,72-year-
old.,male.,who.,has.,hypertension.,and.,diabetes.,mellitus.,and.,smokes.,tobacco
..,-.,correct.,answer.,✔ ✔ d..,A.,72-year-
old.,male.,who.,has.,hypertension.,and.,diabetes.,mellitus.,and.,smokes.,tobacco
..,
Stroke.,risk.,increases.,after.,65.,years.,of.,age..,Strokes.,are.,more.,common.,in.,
men..,Hypertension.,is.,the.,single.,most.,important.,modifiable.,risk.,factor.,for.,
stroke..,Diabetes.,mellitus.,is.,a.,significant.,stroke.,risk.,factor;.,and.,smoking.,n
early.,doubles.,the.,risk.,of.,a.,stroke..,Other.,risk.,factors.,include.,drug.,abuse.,(e
specially.,cocaine),.,high-
dose.,oral.,contraception.,use,.,migraine.,headaches,.,and.,untreated.,heart.,dise
ase.,such.,as.,atrial.,fibrillation.
,The.,nurse.,is.,teaching.,a.,senior.,citizen's.,group.,about.,signs.,and.,symptoms.,o
f.,a.,stroke..,Which.,statement.,by.,the.,nurse.,would.,provide.,accurate.,informat
ion?
a..,"Take.,the.,person.,to.,the.,hospital.,if.,a.,headache.,lasts.,for.,more.,than.,24.,ho
urs."
b..,"Stroke.,symptoms.,usually.,start.,when.,the.,person.,is.,awake.,and.,physicall
y.,active."
c..,"A.,person.,with.,a.,transient.,ischemic.,attack.,has.,mild.,symptoms.,that.,will.
,go.,away."
d..,"Call.,911.,immediately.,if.,a.,person.,develops.,slurred.,speech.,or.,difficulty.
,speaking.".,-.,correct.,answer.,✔ ✔
d..,"Call.,911.,immediately.,if.,a.,person.,develops.,slurred.,speech.,or.,difficul
ty.,speaking."
Medical.,assistance.,should.,be.,obtained.,immediately.,for.,someone.,with.,sig
ns.,and.,symptoms.,of.,a.,stroke.,such.,as.,sudden.,numbness;.,weakness;.,paraly
sis.,of.,the.,face,.,arm,.,or.,leg.,(especially.,on.,one.,side.,of.,the.,body);.,sudden.,co
nfusion;.,trouble.,speaking.,or.,understanding;.,slurred.,speech;.,sudden.,troubl
e.,seeing.,in.,one.,or.,both.,eyes;.,sudden.,trouble.,walking;.,dizziness;.,loss.,of.,ba
lance.,or.,coordination;.,or.,a.,sudden,.,severe.,headache.,with.,no.,known.,cause
..,A.,person.,with.,signs.,and.,symptoms.,of.,a.,transient.,ischemic.,attack.,should.,
seek.,medical.,attention.,immediately.,because.,it.,is.,unknown.,if.,the.,sympto
ms.,will.,resolve.,or.,persist.,and.,progress.,to.,a.,stroke..,Onset.,of.,signs.,and.,sym
ptoms.,of.,a.,stroke.,vary.,depending.,on.,the.,type..,Onset.,of.,an.,ischemic.,throm
botic.,stroke.,usually.,occurs.,at.,rest..,Onset.,of.,an.,ischemic.,embolic.,stroke.,is.,
, not.,related.,to.,rest.,or.,activity,.,and.,onset.,of.,a.,hemorrhagic.,stroke.,usually.,o
ccurs.,with.,activity.
The.,physician.,orders.,alteplase.,(Activase).,for.,a.,58-year-
old.,man.,diagnosed.,with.,an.,acute.,ischemic.,stroke..,Which.,nursing.,action.,i
s.,most.,appropriate?
a..,Administer.,the.,medication.,by.,an.,IV.,route.,at.,15.,mL/hr.,for.,24.,hours.
b..,Insert.,two.,or.,three.,large-
bore.,IV.,catheters.,before.,administering.,the.,medication..,
c..,If.,gingival.,bleeding.,occurs,.,discontinue.,the.,medication.,and.,notify.,the.,p
hysician.
d..,Reduce.,the.,medication.,infusion.,rate.,for.,a.,systolic.,blood.,pressure.,abov
e.,180.,mm.,Hg..,-.,correct.,answer.,✔ ✔ b..,Insert.,two.,or.,three.,large-
bore.,IV.,catheters.,before.,administering.,the.,medication..,
Before.,giving.,alteplase,.,the.,nurse.,should.,start.,two.,or.,three.,large.,bore.,IVs.
.,Bleeding.,is.,a.,major.,complication.,with.,fibrinolytic.,therapy,.,and.,venipunc
tures.,should.,not.,be.,attempted.,after.,alteplase.,is.,administered..,Altepase.,is.,a
dministered.,IV.,with.,an.,initial.,bolus.,dose.,followed.,by.,an.,infusion.,of.,the.,r
emaining.,medication.,within.,the.,next.,60.,minutes..,Gingival.,bleeding.,is.,a.,
minor.,complication.,and.,may.,be.,controlled.,with.,pressure.,or.,ice.,packs..,Co
ntrol.,of.,blood.,pressure.,is.,critical.,prior.,to.,altepase.,administration.,and.,for.,t
he.,following.,24.,hours..,Before.,administering.,altepase,.,a.,systolic.,pressure.,
above.,180.,mm.,Hg.,or.,diastolic.,pressure.,above.,110.,mm.,Hg.,requires.,aggre
ssive.,blood.,pressure.,treatment.,to.,reduce.,the.,risk.,of.,cerebral.,hemorrhage.
The.,nurse.,in.,a.,primary.,care.,provider's.,office.,is.,assessing.,several.,patients.,
today..,Which.,patient.,is.,most.,at.,risk.,for.,a.,stroke?
a..,A.,92-year-
old.,female.,who.,takes.,warfarin.,(Coumadin).,for.,atrial.,fibrillation.
b..,A.,28-year-
old.,male.,who.,uses.,marijuana.,after.,chemotherapy.,to.,control.,nausea.
c..,A.,42-year-
old.,female.,who.,takes.,oral.,contraceptives.,and.,has.,migraine.,headaches.
d..,A.,72-year-
old.,male.,who.,has.,hypertension.,and.,diabetes.,mellitus.,and.,smokes.,tobacco
..,-.,correct.,answer.,✔ ✔ d..,A.,72-year-
old.,male.,who.,has.,hypertension.,and.,diabetes.,mellitus.,and.,smokes.,tobacco
..,
Stroke.,risk.,increases.,after.,65.,years.,of.,age..,Strokes.,are.,more.,common.,in.,
men..,Hypertension.,is.,the.,single.,most.,important.,modifiable.,risk.,factor.,for.,
stroke..,Diabetes.,mellitus.,is.,a.,significant.,stroke.,risk.,factor;.,and.,smoking.,n
early.,doubles.,the.,risk.,of.,a.,stroke..,Other.,risk.,factors.,include.,drug.,abuse.,(e
specially.,cocaine),.,high-
dose.,oral.,contraception.,use,.,migraine.,headaches,.,and.,untreated.,heart.,dise
ase.,such.,as.,atrial.,fibrillation.
,The.,nurse.,is.,teaching.,a.,senior.,citizen's.,group.,about.,signs.,and.,symptoms.,o
f.,a.,stroke..,Which.,statement.,by.,the.,nurse.,would.,provide.,accurate.,informat
ion?
a..,"Take.,the.,person.,to.,the.,hospital.,if.,a.,headache.,lasts.,for.,more.,than.,24.,ho
urs."
b..,"Stroke.,symptoms.,usually.,start.,when.,the.,person.,is.,awake.,and.,physicall
y.,active."
c..,"A.,person.,with.,a.,transient.,ischemic.,attack.,has.,mild.,symptoms.,that.,will.
,go.,away."
d..,"Call.,911.,immediately.,if.,a.,person.,develops.,slurred.,speech.,or.,difficulty.
,speaking.".,-.,correct.,answer.,✔ ✔
d..,"Call.,911.,immediately.,if.,a.,person.,develops.,slurred.,speech.,or.,difficul
ty.,speaking."
Medical.,assistance.,should.,be.,obtained.,immediately.,for.,someone.,with.,sig
ns.,and.,symptoms.,of.,a.,stroke.,such.,as.,sudden.,numbness;.,weakness;.,paraly
sis.,of.,the.,face,.,arm,.,or.,leg.,(especially.,on.,one.,side.,of.,the.,body);.,sudden.,co
nfusion;.,trouble.,speaking.,or.,understanding;.,slurred.,speech;.,sudden.,troubl
e.,seeing.,in.,one.,or.,both.,eyes;.,sudden.,trouble.,walking;.,dizziness;.,loss.,of.,ba
lance.,or.,coordination;.,or.,a.,sudden,.,severe.,headache.,with.,no.,known.,cause
..,A.,person.,with.,signs.,and.,symptoms.,of.,a.,transient.,ischemic.,attack.,should.,
seek.,medical.,attention.,immediately.,because.,it.,is.,unknown.,if.,the.,sympto
ms.,will.,resolve.,or.,persist.,and.,progress.,to.,a.,stroke..,Onset.,of.,signs.,and.,sym
ptoms.,of.,a.,stroke.,vary.,depending.,on.,the.,type..,Onset.,of.,an.,ischemic.,throm
botic.,stroke.,usually.,occurs.,at.,rest..,Onset.,of.,an.,ischemic.,embolic.,stroke.,is.,
, not.,related.,to.,rest.,or.,activity,.,and.,onset.,of.,a.,hemorrhagic.,stroke.,usually.,o
ccurs.,with.,activity.
The.,physician.,orders.,alteplase.,(Activase).,for.,a.,58-year-
old.,man.,diagnosed.,with.,an.,acute.,ischemic.,stroke..,Which.,nursing.,action.,i
s.,most.,appropriate?
a..,Administer.,the.,medication.,by.,an.,IV.,route.,at.,15.,mL/hr.,for.,24.,hours.
b..,Insert.,two.,or.,three.,large-
bore.,IV.,catheters.,before.,administering.,the.,medication..,
c..,If.,gingival.,bleeding.,occurs,.,discontinue.,the.,medication.,and.,notify.,the.,p
hysician.
d..,Reduce.,the.,medication.,infusion.,rate.,for.,a.,systolic.,blood.,pressure.,abov
e.,180.,mm.,Hg..,-.,correct.,answer.,✔ ✔ b..,Insert.,two.,or.,three.,large-
bore.,IV.,catheters.,before.,administering.,the.,medication..,
Before.,giving.,alteplase,.,the.,nurse.,should.,start.,two.,or.,three.,large.,bore.,IVs.
.,Bleeding.,is.,a.,major.,complication.,with.,fibrinolytic.,therapy,.,and.,venipunc
tures.,should.,not.,be.,attempted.,after.,alteplase.,is.,administered..,Altepase.,is.,a
dministered.,IV.,with.,an.,initial.,bolus.,dose.,followed.,by.,an.,infusion.,of.,the.,r
emaining.,medication.,within.,the.,next.,60.,minutes..,Gingival.,bleeding.,is.,a.,
minor.,complication.,and.,may.,be.,controlled.,with.,pressure.,or.,ice.,packs..,Co
ntrol.,of.,blood.,pressure.,is.,critical.,prior.,to.,altepase.,administration.,and.,for.,t
he.,following.,24.,hours..,Before.,administering.,altepase,.,a.,systolic.,pressure.,
above.,180.,mm.,Hg.,or.,diastolic.,pressure.,above.,110.,mm.,Hg.,requires.,aggre
ssive.,blood.,pressure.,treatment.,to.,reduce.,the.,risk.,of.,cerebral.,hemorrhage.
