NURSl 5463/l NURS5463l Examl 5l (Newl
2026/l 2027l Update)l Adultl Gerontologyl
Acutel Carel Review|l Questionsl &l
Answersl |l Gradel A|l 100%l Correctl
(Verifiedl Solutions)-l UTA
QUESTION
Dosingl ofl tPA
Answer:
-weightl based,l 0.9mg/kgl withl al maxl ofl 90mgl infusedl overl 60l min.
-10%l ofl totall ofl dosel isl givenl asl initiall bolusl overl 1l min.
-Heparinl isl notl recommendedl forl acutel stroke
QUESTION
Updatedl tPAl guidelinesl 2015-Exclusionl criteria
Answer:
-hypo-densityl greaterl thanl 1/3l ofl headl CT
-hxl ofl previousl intracraniall hemorrhage
-intracraniall neoplasm,l arteriovenousl malformation,l orl aneurysml
-significantl headl trauma,l stroke,l orl MIl inl pastl 3l months
-recentl intracraniall orl intraspinall surgery
-infectivel endocarditisl asl thel causel ofl cerebrall embolism
-plateletl countl <l 100,000,l abnormallyl elevatedl aPTT,l INRl >1.7l orl PTl >15l secondsl
-currentl usel ofl directl thrombin,l factorl Xal inhibitorsl withinl 48l hoursl orl ifl al sensitivel
labl testl arel elevatedl (aPTT,l INR,l ECT,l TTl orl factorl Xal assay)
-severelyl elevatedl BPl (>l 185/110mmHg)
QUESTION
,Updatedl tPAl guidelinesl 2015-Exclusionl criterial (continued)
Answer:
-BSl concentrationl <l 50mg/dL
-pregnancy
-majorl surgeryl orl seriousl traumal withl inl thel pastl 14l days
-GI/GUl hemorrhagel withinl 21l days
-rapidlyl improvingl symptomsl
-seizurel atl onsetl withl postictall residuall impairments
-Arteriall puncturel atl thel nonl compressiblel sitel lastl 7d
-suggestivel ofl subarachnoidl hemorrhage
QUESTION
Relativel contraindicationl tol extendl thel Treatmentl Windowl tol 4.5hr.
Answer:
-Agel >l 80y.o.
-NIHSSl >l 25
-anyl anticoagulantl usagel regardlessl ofl coagulationl studyl results
-Thel patientl hasl bothl DMl andl hxl ofl previousl stroke
-Basedl onl clinicall discernmentl mayl receivel tPAl despitel 1l orl morel ofl thesel relativel
contraindications
QUESTION
Complicationsl tol tPA-l actions
Answer:
-suddenl declinel inl mentall status
-stopl tPA
-obtainl STATl CTl Head,l
-notifyl neurosurgery
-Labs:l STATl coats,l CBC,l fibrinogen,l T/Sl forl 2-4l unitsl PRBC
-followl ICHl reversall protocol:l Factorl VIIal &l IV,l platelets,l cryoprecipitate
QUESTION
, Primaryl strokel preventionl (2014)
Answer:
-AHA/ACCl CVl riskl calculator-10l yrl riskl ofl CVA/MI
-CHA2DS2-VASc-calculatesl riskl ofl strokel inl ptl withl NVAFl (nonl valvularl a-fib?)
-physicall activity:l moderatel tol vigorousl intensityl aerobicl activityl atl leastl 40l minl perl
day,l 3-4l daysl perl week
-highl 10-yearl cardiovascularl risk-initiatel statinl therapy
-Ezetimibel mayl providel anl optionl forl statin-intolerantl patientsl
-DM:l targetl BPl <140/90,l statin
-smokingl cessation,l drugl andl counseling
QUESTION
Treatmentl forl SBPl >l 160
Answer:
-twol antihypertensivel medication:l diureticl andl ACEl inhibitor
QUESTION
Overweight,l obesel BMIl numbers
Answer:
-Overweightl =l 25-29l kg/m2
-Obesel =l BMIl >l 30l kg/m2
QUESTION
Primaryl strokel preventionl (2014)l Valvularl a-fib
Answer:
-CHA2DS2-VAScl scorel >2:l initiatel long-terml warfarinl therapy;l targetl INRl 2.0-3.0
QUESTION
Primaryl strokel preventionl (2014)l nonl valvularl a-fib
2026/l 2027l Update)l Adultl Gerontologyl
Acutel Carel Review|l Questionsl &l
Answersl |l Gradel A|l 100%l Correctl
(Verifiedl Solutions)-l UTA
QUESTION
Dosingl ofl tPA
Answer:
-weightl based,l 0.9mg/kgl withl al maxl ofl 90mgl infusedl overl 60l min.
-10%l ofl totall ofl dosel isl givenl asl initiall bolusl overl 1l min.
-Heparinl isl notl recommendedl forl acutel stroke
QUESTION
Updatedl tPAl guidelinesl 2015-Exclusionl criteria
Answer:
-hypo-densityl greaterl thanl 1/3l ofl headl CT
-hxl ofl previousl intracraniall hemorrhage
-intracraniall neoplasm,l arteriovenousl malformation,l orl aneurysml
-significantl headl trauma,l stroke,l orl MIl inl pastl 3l months
-recentl intracraniall orl intraspinall surgery
-infectivel endocarditisl asl thel causel ofl cerebrall embolism
-plateletl countl <l 100,000,l abnormallyl elevatedl aPTT,l INRl >1.7l orl PTl >15l secondsl
-currentl usel ofl directl thrombin,l factorl Xal inhibitorsl withinl 48l hoursl orl ifl al sensitivel
labl testl arel elevatedl (aPTT,l INR,l ECT,l TTl orl factorl Xal assay)
-severelyl elevatedl BPl (>l 185/110mmHg)
QUESTION
,Updatedl tPAl guidelinesl 2015-Exclusionl criterial (continued)
Answer:
-BSl concentrationl <l 50mg/dL
-pregnancy
-majorl surgeryl orl seriousl traumal withl inl thel pastl 14l days
-GI/GUl hemorrhagel withinl 21l days
-rapidlyl improvingl symptomsl
-seizurel atl onsetl withl postictall residuall impairments
-Arteriall puncturel atl thel nonl compressiblel sitel lastl 7d
-suggestivel ofl subarachnoidl hemorrhage
QUESTION
Relativel contraindicationl tol extendl thel Treatmentl Windowl tol 4.5hr.
Answer:
-Agel >l 80y.o.
-NIHSSl >l 25
-anyl anticoagulantl usagel regardlessl ofl coagulationl studyl results
-Thel patientl hasl bothl DMl andl hxl ofl previousl stroke
-Basedl onl clinicall discernmentl mayl receivel tPAl despitel 1l orl morel ofl thesel relativel
contraindications
QUESTION
Complicationsl tol tPA-l actions
Answer:
-suddenl declinel inl mentall status
-stopl tPA
-obtainl STATl CTl Head,l
-notifyl neurosurgery
-Labs:l STATl coats,l CBC,l fibrinogen,l T/Sl forl 2-4l unitsl PRBC
-followl ICHl reversall protocol:l Factorl VIIal &l IV,l platelets,l cryoprecipitate
QUESTION
, Primaryl strokel preventionl (2014)
Answer:
-AHA/ACCl CVl riskl calculator-10l yrl riskl ofl CVA/MI
-CHA2DS2-VASc-calculatesl riskl ofl strokel inl ptl withl NVAFl (nonl valvularl a-fib?)
-physicall activity:l moderatel tol vigorousl intensityl aerobicl activityl atl leastl 40l minl perl
day,l 3-4l daysl perl week
-highl 10-yearl cardiovascularl risk-initiatel statinl therapy
-Ezetimibel mayl providel anl optionl forl statin-intolerantl patientsl
-DM:l targetl BPl <140/90,l statin
-smokingl cessation,l drugl andl counseling
QUESTION
Treatmentl forl SBPl >l 160
Answer:
-twol antihypertensivel medication:l diureticl andl ACEl inhibitor
QUESTION
Overweight,l obesel BMIl numbers
Answer:
-Overweightl =l 25-29l kg/m2
-Obesel =l BMIl >l 30l kg/m2
QUESTION
Primaryl strokel preventionl (2014)l Valvularl a-fib
Answer:
-CHA2DS2-VAScl scorel >2:l initiatel long-terml warfarinl therapy;l targetl INRl 2.0-3.0
QUESTION
Primaryl strokel preventionl (2014)l nonl valvularl a-fib
