Acute Ischemic Stroke

Question 1

The tissue surrounding the ischemic area that is salvageable

Answer 1

Penumbra

Question 2

A transient episode of neurologic dysfunction due to focal brain, spinal cord or retinal ischemia without tissue injury or acute infarction

Answer 2

Transient Ischemic Attack (TIA)

Question 3

The most common motor dysfunction that is caused by a lesion of the opposite side of the Brain.

Answer 3

Hemiplegia

Question 4

What is the risk score of a client with: Age: 40 y/o; BP: 110/90; with Unilateral weakness; lasts for 10-59 minutes; and on medication (Insulin)

Answer 4

4

Question 5

A type of aphasia in which client B3 is able to deliver his speech well and able to comprehend the spoken messages by the Nurse but unable to copy and replicate the words relay to him.

Answer 5

Conduction Aphasia

Question 6

Patient A.I.S is experiencing aphasia, right hemiparesis, right-sided sensory loss, right visual field defect, poor right conjugate gaze, dysarthria, difficulty in reading, writing, or calculating. What hemisphere is being affected?

Answer 6

Left (Dominant) Hemisphere

Question 7

You performed an assessment on patient I.A.S this morning, you noticed that she has decreased sensation of face and limbs on one side of the body however, there are abnormalities of higher brain function, motor function, or vision. What neurological abnormality is the patient presenting?

Answer 7

Small Subcortical Hemisphere or Brainstem (Pure Sensory Stroke)

Question 8

The biomarkers for identifying patient at high risk for major adverse cardiac events that predominantly indicating myocardial necrosis

Answer 8

CK-MB fraction, myoglobin, cardiac troponins

Question 9

This shows a superior image quality of the heart particularly for posterior cardiac structures which are nearer to the esophagus, this provides a thorough assessment of the cardiac causes of stroke.

Answer 9

Transthoracic/ transesophageal echocardiography

Question 10

What is the Braden Scale?

Answer 10

Used to assess and document a patient’s risk for developing pressure injuries

Question 11

What are the possible nursing diagnosis for stroke?

Answer 11

Altered tissue perfusion, Impaired physical mobility and Disturbed sensory perception

Question 12

Which of the following is the best treatment for acute ischemic stroke?

Answer 12

Alteplase

Question 13

What medication is commonly used to restore blood flow, minimize the ischemic penumbra and limit the infarction volume.

Answer 13

Thrombolytic therapy rt-PA or Tissue Plasminogen Activator, Recombinant

Question 14

What is the recommended dose for rTPA?

Answer 14

0.9mg/kg with 10% total dose (given as bolus over 1-2 mins and remainder as infusion over 1 hr)

Question 15

It is given to prevent recurrent stroke 1-2 days after the initial event

Answer 15

Aspirin

Question 16

What is the SBP & DBP for thrombolytic candidates and its treatment?

Answer 16

SBP: >185 mmHg, DBP: 110 mmHg; treatment: 1-2 inches of nitroglycerine paste (nitropaste) or 1-2 doses of 10-20 mg of labetalol given via IVP

Question 17

During and after the treatment phase, what is the guideline for monitoring the BP?

Answer 17

BP is monitored every 12 min for 2hrs, then every 30 mins for 6 hrs, and then hourly for 16hrs

Question 18

What is the optimal bed positioning for patients with increased ICP?

Answer 18

Head of bed flat or elevation of 30 degrees

Question 19

What is the purpose of temperature checks in patients with increased ICP?

Answer 19

Cerebral blood flow increases in patients with increased body temperature, further increasing rise in ICP

Question 20

The incidence of ischemic stroke in patients with TIAs and other risk factors is reduced with the administration of which medication?

Answer 20

Daily low dose aspirin