NSG 223 - Medical-Surgical Nursing II
Exam 4
Question:
Loss of Proprioception
Answer:
Loss of proprioception: ability to perceive the position of your body in space
Question:
Ischemic Stroke Symptoms
Answer:
Hemiplegia Hemiparesis Dysarthria Apraxia Dysphasia Dysphagia
Aphasia: difficulty communicating
Expressive: Cannot answer, knows answer but cannot get it out
Receptive: Do not understand what you are saying 1 / 4
Global: Both
Loss of proprioception: ability to perceive the position of your body in space
Facial Droop
Question:
Hemorrhagic Stroke Nursing Assessment
Answer:
CT MRI to determine extent of damage Under 40- Drug Screen No Lumbar Puncture
Aneurysm Precautions: bed rest laying down, dim lights, SCD (leg
squeezers), need them to turn still, stool softeners
Environment: Quiet, head of bed 30 degrees
Bowel/Bladder Lighting Prevention Bed Rest Sedation If INR high, use Vitamin K and plasma
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Question:
Hemorrhagic Pharmacological Treatment
Answer:
If caused by elevated INR due to Warfarin Reverse INR with FFP and Vitamin K
If caused by NOACs: Idarucizumab (Praxbind) reverses dabigatran (Pradaxa)
Seizures: phenytoin (Dilantin) (more likely for seizures)
Anti-hypertensives (ACE favored) Analgesics for pain Acetaminophen for fever Antidepressants
Question:
Ischemic Pharmacological Treatment
Answer:
Anticoagulants: Warfarin INR Goal 2-3
NOACs: do not have to check INR or APTT often
Dabigatran (Pradaxa) (only one with reversal) Apixaban (Eliquis) & Edoxaban (Savaysa) & Rivaroxaban (Xarelto)
Antiplatelet: Plavix & Aspirin
Statins: Helpful in reducing risk of ischemic stroke (even in those who do
not need their cholesterol decreased)
Antihypertensives: (ACE preferred with or without a diuretic)
Oxygen 3 / 4
THROMBOLYTICS (tPA, Alteplase) Clot Buster- ISCHEMIC ONLY, symptoms started less than 3 hours ago.
Question:
Cataract Discharge Teaching
Answer:
An eye shield is usually worn at night for the first week to avoid injury. The nurse also explains that there should be minimal discomfort after surgery and educates the patient about taking a mild analgesic agent, such as acetaminophen, as needed. Antibiotic, anti-inflammatory, and corticosteroid eye drops or ointments are prescribed postoperatively. Patients prescribed anti-inflammatory or corticosteroid eye drops are monitored for possible increases in IOP
Question:
Macular Degeneration Patient Education
Answer:
Amsler grids are given to patients to use in their homes to monitor for a sudden onset or distortion of vision. These may provide the earliest sign that macular degeneration is getting worse. Patients should be encouraged to look at these grids, one eye at a time, several times each week with glasses on if needed for corrected near vision. If there is a change in the way the grid appears to the patient (e.g., if the lines or squares appear distorted or faded), the patient should notify the ophthalmologist immediately and should arrange to be seen promptly
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