NUR 426 Exam 3 Review Questions and Correct Answers
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Course
NUR 426
Institution
NUR 426
What is an ischemic stroke? the occlusion of an artery by either a thrombus or an embolus
What is a hemorrhagic stroke? bleeding in the brain tissue or the subarachnoid area due to vessel integrity being interrupted
What is a transient ischemia attack (tia)? brief interruption in cerebral blood f...
NUR 426 Exam 3 Review Questions and
Correct Answers
What is an ischemic stroke? ✅the occlusion of an artery by either a thrombus or an
embolus
What is a hemorrhagic stroke? ✅bleeding in the brain tissue or the subarachnoid area
due to vessel integrity being interrupted
What is a transient ischemia attack (tia)? ✅brief interruption in cerebral blood flow
(mini stroke)
What are the risk factors for stroke? ✅-afib
-high cholesterol
-htn
-smoking
-diabetes
-obesity
-use of oral contraceptives
-post mi
-genetics
-endocarditis
-cocaine use
-heart valve disease
What are the abcs of stroke prevention education? ✅a-aspiring use when appropriate
(81mg/day)
B- blood pressure control
C- cholesterol management (diet modification, medications)
S- smoking cessation
What are the signs and symptoms of stroke? ✅-one side facial droop
-weakness on one side
-numbness or altered sensation
-headache, dizziness
-unresponsive or collapse
-trouble with balance
-difficulty speaking
-ams
* symptoms are on one side*
What is the number one question to ask a patient that presents with stroke symptoms?
✅when id the symptoms start
,-determines the treatment style
Assessment questions for stroke ✅-when did the symptoms start
-what were you doing when the symptoms started
-how did the symptoms progress
-have the symptoms improved
-what is your medical history (hx of stroke, hx of recent bleeding, tbii, afib, drug use)
-what meds are you currently on
Assessment data you ask/find out for stroke ✅-accurate weight of the patient
-full set of vitals
-blood glucose asap (may just be hypoglycemia)
-find out if they have a headache and if its the worst headache of their life (hemorrhagic
can feel like a crushing pain)
What is the max time limit you need to get a patient to the cta from when they walk in
the door? ✅25 minutes
Why do you get a ct scan for a patient with stroke like symptoms? ✅you want to see if
there is presence of blood to determine if it is a hemorrhagic stroke or not
What important information do we document before providing stroke treatment? ✅-
accurate weight
-last known well
-hx of stroke
-blood pressure
-gcs
-dysphagia screen
-nihss
For ischemic strokes, what early intervention is the standard of practice to improve
blood flow to viable tissue? ✅tissue plasminogen activator (r-tpa)
Alteplase
-dependent on the interval between the time the symptoms began and treatment is
available
What is tpa? ✅a fda approved clot busting agent
How long do you have from beginning of stroke symptoms to administration of tpa?
✅3-4.5 hours of last known well
Before administering tpa, what do you need to know/obtain? ✅-weight
-bp
-lkw
-signs of bleeding
, -blood sugar
-confirmed ct shows no bleeding
-hx of bleeding or stroke
-current meds
-allergies
-airway (abcs)
A patient cannot receive tpa if their blood pressure is _________, if the patient has had
recent internal bleeding within __________, or had a recent stroke. ✅-185/110 or
higher
-3 months
The goal is to start treatment within how much time after arrival? ✅45 minutes
How is tpa administered? ✅reconstituted at bedside, based on the patients weight
What are the steps to the administration of tpa? ✅-ensure accurate weight and lnw is
obtained
-verify order and patient consent
-check bp
-ensure the patient has two patent large bore ivs
-mix tpa with saline by gently rolling. Never shake
-spike administration set and prime tubing
-follow hospital policy for removal/administration dose
-verify waste, bolus, and pump administration with a second rn
During the administration of tpa, how long do you stay with the patient? What do you
check? ✅the entire one hour infusion
-q15min neuro checks
After the administration of tpa, what do we do? ✅-flush the line with 50ml normal saline
-monitor q3omin neuro checks
-frequently assess the airway
What assessment finding would be cause to immediately stop the infusion ✅-bleeding
-ams
After tpa, what do we not do to the patient? ✅-no invasive procedures
-no im shots
-trauma
-excessive movement of the patient
-no foley
After tpa, what tests may be altered and unreliable? ✅clotting tests
-ptt
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