Potential candidate for thrombolytic therapy

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Reference no: EM133881168

Questions

Test for Stroke: Ischemic Stroke Treatment

1. A brief neurologic examination of a patient in the emergency department suggests that a stroke may have occurred. Which action should the nurse take first?

Draw a blood glucose level.
Schedule an emergency computed tomography (CT) scan.
Notify the hospital's stroke team and activate the stroke protocol.

2. A widower who lives with an adult child comes to the emergency department with neurologic symptoms that suggest a stroke. The patient says, "I was fine when I went to bed. But when I woke up, my entire left side was weak." Knowing this, what is the best way for you to determine the time of symptom onset?

Ask the patient, "What time did you go to bed?"
Ask the patient, "What time did you get out of bed this morning?"
Ask the patient, "Did you get up at any point during the night?"

3. A patient with a possible ischemic stroke is a potential candidate for thrombolytic therapy. Which laboratory test result should you obtain first?

Blood glucose level
Clotting study results
Cardiac marker levels

4. When providing care for a patient in the emergency department suspected of having an ischemic stroke, which practitioner order has the highest priority?

Obtain a complete blood count (CBC).
Perform a chest X-ray.
Arrange for a non-contrast-enhanced computed tomography (CT) scan.

5. A patient in the emergency department who exhibits stroke symptoms is awaiting an emergency computed tomography scan. The patient's vital signs are as follows: blood pressure (BP), 180/110 mm Hg; heart rate, 84 beats/minute and regular; respirations, 12 breaths/minute; and temperature, 100.4 °F (38 °C). Which nursing action has the highest priority?

Contact the practitioner about the patient's elevated BP.
Administer acetaminophen per rectum, as ordered, to reduce the elevated temperature.
Obtain an electrocardiogram (ECG) to ensure that the patient doesn't have arrhythmia.

6. A patient is about to undergo thrombolytic therapy. Which nursing action should you implement first?

Perform a comprehensive neurologic assessment.
Insert two or three IV lines.
Perform a swallow test.

7. A patient is preparing to undergo thrombolytic therapy. While interviewing the patient's spouse, you discover additional information. Which piece of information should you report to the practitioner immediately?

The patient's symptoms began almost 3 hours earlier.
The patient takes medication to control hypertension.
The patient had a kidney removed 2 weeks ago.

8. The nurse is preparing to administer recombinant tissue plasminogen activator (rt-PA) to a patient with acute ischemic stroke. The nurse has already calculated the dose carefully and drawn up the waste amount. Which of the following should be the nurse's best action?

Administer the first 10% of the dose as a bolus over 1 minute.
Connect the rt-PA bottle to the IV pump for infusion over the next hour.
Verify the waste amount with another nurse.

9. A 57-year-old woman comes to the emergency department with stroke-like symptoms that started about 3 hours earlier. The assessment revealed no prior stroke, no history of anticoagulant use, and no diabetes. Imaging reveals the involvement of less than one-third of the middle cerebral artery. Based on this information, which treatment should the practitioner prescribe as the best option for this patient?

Thrombolytic therapy
Intra-arterial fibrinolysis
Mechanical clot removal

10. During the first 2 hours after thrombolytic therapy, which nursing action has the highest priority?

Observing for angioedema
Monitoring blood pressure (BP)
Watching for cerebral edema.

Reference no: EM133881168

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