N352 Exam 4: Altered Cerebral Tissue Perfusion, N352 Cardiac and Peripheral Perfusion Study Guide, N352 Oncology Study Guide Questions & Answers 100% Accurate (rated a+)

Discuss approaches to modifying the primary risk factors of stroke - correct answer A significant risk factor for stroke is hypertension, followed by cigarette smoking. Other modifiable risk factors include hypercholesterolemia and illicit drug use (cocaine use is associated with ICH). Major nonmodifiable risk factors include age greater than 55, gender, and race. Describe the classic warning signs of stroke using the FAST acronym - correct answer .FACE: Ask the person to smile. Does one side of the face droop? ARMS: Ask the person to raise both arms. Does one arm drift downward? SPEECH: Ask the person to repeat a simple phrase. Is their speech slurred or strange? TIME: If you observe any of these signs, call 9-1-1 immediately. Differentiate ischemic stroke from hemorrhagic stroke - correct answer .Ischemic Stroke (87%) - blockage - Atherosclerosis - Embolic/cardiogenic - Vasospasm - Inflammation Hemorrhagic Stroke (13%) - burst - Intracerebral hematoma (ICH) (10%) - Subarachnoid hemorrhage (SAH) (3%) Left middle cerebral artery stroke manifestations - correct answer --Weakness of the right face, arm, and leg (arm weakness greater than leg weakness) --Decrease in sensation on the right side of the body --Right homonymous hemianopia (loss of vision in the right temporal field of vision and left nasal field of vision, requiring patients to scan an area in order to visualize objects on their right side) --Dysphasia—in most patients, the language center of the brain is located in the left hemisphere. Language deficits may involve the motor speech area (Broca's area) and cause patients to have difficulty expressing thoughts and to make errors in speech that they are able to detect. Injury or ischemia to the sensory speech area (Wernicke's area) results in an inability to process speech input in the brain, causing patients to make errors in speech of which they are unaware. --Inattention or neglect of the right side Right middle cerebral artery stroke manifestations - correct answer --Weakness of the left face, arm, and leg (arm weakness greater than leg weakness) --Decrease in sensation on the left side of the body --Left homonymous hemianopia (loss of vision in the left temporal field of vision and right nasal field of vision, requiring patients to scan an area in order to visualize objects on their right side) --Inattention or neglect of the left side Basilar artery Stroke manifestations - correct answer --Dizziness --Ataxia --Tinnitus --Nausea and vomiting --Weakness on one side of the body that may be ipsilateral to the side of ischemia or injury or contralateral --Decrease in sensation on one side of the body that may be ipsilateral to the side of ischemia or injury or contralateral --Difficulty in the articulation of speech --Difficulty with swallowing and managing oral secretions. Describe the pharmacologic treatment to prevent stroke - correct answer .antihypertensives: - beta blockers -Ca channel blockers -diuretics lipid-lowering: - statins - niacin - bile acid sequestrants Platelet inhibitors: Anticoagulants: - heparin - warfarin - pradaxa Describe diagnostic studies performed for people experiencing a CVA - correct answer .- CT scan - MRI - doppler ultrasound - cerebral angiography - endocardiography - laboratory tests (for hypercoagulability) Describe the pharmacologic treatment to treat ischemic stroke. - correct answer thromoblytics (recombinant tissue plasminogen activator [rtPA]) Describe the nursing considerations associated with rTPa administration. - correct answer - monitor s/s for excess bleeding - mitigate invasive procdures that could produce excessive bleeding - Lab tests: Coagulation tests including a PTT, bleeding time, PT, TT, INR - Keep patient in bed while receiving this medication. - Check vital signs frequently. - Stop therapy if dysrhythmias occur - Use the radial artery to draw ABGs Describe the acute medical and nursing management of patients who have had a stroke - correct answer .Optimizing Function and Preventing Complications w/ regard to deficits in: - sensory/perceptual - motor - speach Describe acute and long term nursing management related to nutrition, communication, safety, and self-care following stroke. - correct answer • Restoring self-care abilities • Preventing complications related to chronic deficits - Safety/falls - Aspiration pneumonia - Skin issues •Discuss the signs of cerebral hypoperfusion of any cause. - correct answer • CHANGE IN LEVEL OF CONSCIOUSNESS • Other signs depend on area of brain affected - Changes in speech or thought pattern - Changes in motor function on one side of body - Sensory-perceptual deficits • Vision - Cognitive-emotional changes