A patient admitted with possible stroke has been aphasic for 3 ...

[scienceeasy]

A patient admitted with possible stroke has been aphasic for 3 hours and his current blood pressure (BP) is 174/94 mm Hg. Which order by the health care provider should the nurse question?
 
  a. Keep head of bed elevated at least 30 degrees.
  b. Infuse normal saline intravenously at 75 mL/hr.
  c. Administer tissue plasminogen activator (tPA) per protocol.
  d. Administer a labetalol (Normodyne) drip to keep BP less than 140/90 mm Hg.

Question 2

During the change of shift report a nurse is told that a patient has an occluded left posterior cerebral artery. The nurse will anticipate that the patient may have
 
  a. dysphasia.
  b. confusion.
  c. visual deficits.
  d. poor judgment.

[tuate]

Answer to Question 1

ANS: D
Because elevated BP may be a protective response to maintain cerebral perfusion, antihypertensive therapy is recommended only if mean arterial pressure (MAP) is >130 mm Hg or systolic pressure is >220 mm Hg. Fluid intake should be 1500 to 2000 mL daily to maintain cerebral blood flow. The head of the bed should be elevated to at least 30 degrees, unless the patient has symptoms of poor tissue perfusion. tPA may be administered if the patient meets the other criteria for tPA use.

Answer to Question 2

ANS: C
Visual disturbances are expected with posterior cerebral artery occlusion. Aphasia occurs with middle cerebral artery involvement. Cognitive deficits and changes in judgment are more typical of anterior cerebral artery occlusion.

[scienceeasy]

TYSM

[vickyvicksss]

Excellent