Nursing III Final Chapters

Nursing III Final Chapters Chapter 35 For the client who is at risk for stroke, the most important guideline the nurse should teach is to: monitor blood pressure The family of a client diagnosed with a stroke asks the nurse if this health problem is very common. The nurse should respond that in the United States a person has a stroke every: 40 seconds A client is being evaluated for a stroke. The nurse knows that one of the easiest and most common diagnostic tests used to differentiate between strokes is: computed tomography (CT) While instructing a client on stroke prevention, the nurse mentions medications that are useful in stroke prevention. The following medications are effective in preventing a stroke, EXCEPT: Anticholinergics A client is being seen in the emergency department experiencing symptoms of a stroke. The nurse realizes that the administration of a medication to break clots, such as tPA, should be administered within how many minutes of the client presenting to the emergency department? 60 minutes The nurse, caring for a client with a traumatic brain injury, realizes that the major cause of these types of injuries is: motor vehicle crashes A client is diagnosed with a mild brain injury. Which of the following is an example of a mild injury? Concussion The nurse, caring for a client recovering from a traumatic brain injury, knows the client and the family are eligible for specific federal programs because of the: Traumatic Brain Injury Act of 2008 The nurse is planning care for a client diagnosed with increased intracranial pressure after a head injury. Which of the following interventions can be used to reduce increased intracranial pressure? Administer corticosteroids and osmotic diuretics as prescribed Which of the following should be avoided when caring for a client diagnosed with increased intracranial pressure? Placing the bed in Trendelenburg A client is being instructed on treatments available for a newly diagnosed brain tumor. The nurse realizes that this client's treatment could include all of the following EXCEPT: photo DNA therapy A client diagnosed with an embolic stroke is not a candidate for tPA. The nurse realizes that the client might be eligible for which of the following forms of treatment? Carotid stenting A client diagnosed with a brain tumor is going to receive chemotherapy. The nurse realizes that which of the following medications would most likely be prescribed for this client's treatment? Carmustine A client, being tested for a stroke, is not a candidate for tPA. Which of the following would be contraindicated for the use of tPA? (Select all that apply.) Minor ischemic stroke within 30 days Blood pressure 190/120 mmHg Lumbar puncture 2 days ago Stroke onset 5 hours ago The nurse, planning care for a client recovering from a traumatic brain injury, is including interventions to prevent sympathetic storming. Which of the following should be included in this client's plan of care? (Select all that apply.) Medicate for pain prior to conducting a painful procedure Provide beta-blockers as prescribed with symptoms of sympathetic storm The nurse is providing discharge instructions to a client recovering from a traumatic brain injury. Which of the following should be included in these instructions? (Select all that apply.) Acquire medical clearance prior to returning to work that uses heavy equipment Avoid all illicit drug use Eat a well-balanced diet A client asks the nurse to explain symptoms that would indicate the presence of a brain tumor. Which of the following should the nurse respond to this client? (Select all that apply.) Dizziness is a common symptom Ringing or buzzing in the ears can occur Seizures may occur A headache is usually experienced by 50% of all people diagnosed with a brain tumor The nurse is instructing a client diagnosed with a brain tumor on symptoms to immediately report to her physician. Which of the following should be included in these instructions? (Select all that apply.) New onset of seizures One-sided weakness Loss of balance Problems with vision Inability to talk The nurse, caring for a client diagnosed with a brain tumor, is planning interventions to assist with swallowing and prevent aspiration. Which of the following would be appropriate for this client? (Select all that apply.) Instruct the client to tuck the chin with each swallow Instruct the client to turn the head toward the weak side to swallow Instruct the client to hold the breath while swallowing Instruct the client to sit in an upright position when eating ...Continued...