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Nurse 644 Exam 2 questions with correct answers
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Nurse 644 Exam 2 questions with correct answers
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Nurse 644 Exam 2 questions with correct answersGlasgow Coma Scale Correct Answer-eyes, verbal, motor best score 15
worst score 3 (see picture)
What is the NIH scale? How do we use it? Correct Answer-a neurologic
exam used to test stroke severity. there are 11 items, adding up from 0-
42
Ischemic stroke Correct Answer-abrupt onset of focal neurological
deficit, brain ischemia d/t thrombosis, embolism, or systemic
hypoperfusion. 3 types: thrombosis, embolism and systemic
hypoperfusion
hemorrhagic stroke Correct Answer-brain hemorrhage d/t intracerebral
hemorrhage or subarachnoid hemorrhage.
ischemic stroke management Correct Answer-NIH, CT rule out
hemorrhage, thorough history including medications to exclude NOAC's
or warfin, draw PT/INR, r/o hypoglycemia
ischemic stroke causes Correct Answer-HTN, trauma, bleeding
diatheses, amyloid angiopathy, illicit drug use, vascular malformations
ischemic stroke treatment Correct Answer-lower blood pressure <
185/110
if tPA given keep bp 180/105
, if no tPA permissive HTN < 220/120
use nicardipine, clevidipine, lopress or &PRN labetalol to lower bp
administer tPA (make sure all tubes and lines have been placed)
admit to ICU for close 24 hr. neuro monitoring
elderly often hypovolemic and need IVF. avoid free water or dextrose
containing fluids. keep patient euvolemic with bg 140-180
Endovascular intervention Correct Answer-received tPA within 4.5
hrs.causative occlusion of the internal carotid or proximal MCA, NIH
>6, age > 18, treatment started within 6 hrs. of symptom onset
Subdural Hematoma: blood gathers between the inner layer of the dura
mater. usually d/t tears in bridging veins crossing the subdural space
Correct Answer-reverse anticoagulation with PCC (preferred), FFP,
warfin with vitamin K, need neurosurgery eval and will most likely need
surgical burr hole/craniectomy. neurosurgery looks at age, CT, acuity of
hemorrhage, initial presentation, and neurologic decline
when may a patient need a surgical intervention regarding head bleeds
Correct Answer-clot > 10mm or midline shift > 5mm; gcs decrease > 2
Subarachnoid hemorrhage Correct Answer-Bleeding into the
subarachnoid space, area between the arachnoid membrane and the pia
mater surrounding the brain
Subarachnoid hemorrhage management Correct Answer-High mortality
rate. Bp <160's systolic. Keep euvolemic. Need seizure prophylaxis.
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