A patient in the emergency department is experiencing a massive ...

[folubunmi]

A patient in the emergency department is experiencing a massive stroke with extremely low blood flow to the brain exhibited by a BP less than 60 mm Hg.
 
  The nurse suddenly notes there is a sharp rise in the BP to 250 mm Hg. This high BP lasts about 5 minutes, and then the BP drops sharply again. The pathophysiologic principle behind this is likely due to the
  A)
  activation of the autonomic nervous system.
  B)
  release of mineralocorticoids.
  C)
  CNS ischemic response.
  D)
  protective homeostatic mechanism.

Question 2

An elderly patient arrives to the health care provider's office complaining of a sore that would not heal on his lower leg.
 
  Upon assessment, the nurse finds thin, shiny, bluish brown pigmented desquamative skin. It is located medially over the lower leg. The nurse will educate the patient that the usual treatment is
  A)
  hydrotherapy to facilitate improvement in circulation.
  B)
  compression therapy to help facilitate blood flow back to the vena cava.
  C)
  initiation of Coumadin therapy to maintain an INR of 2 to 3 above norm.
  D)
  long-term antibiotic therapy to facilitate healing of the wound.

[patma1981]

Answer to Question 1

Ans:
C

Feedback:

When blood flow to the brain has been sufficiently interrupted to cause ischemia of the vasomotor center, these vasomotor neurons become strongly excited. This causes massive vasoconstriction as a means of raising the blood pressure to levels as high as the heart can pump against. This response is called the CNS ischemic response and can raise BP to levels as high as 270 mm Hg for as long as 10 minutes.

Answer to Question 2

Ans:
B

Feedback:

: Treatment of venous ulcers includes compression therapy with dressings and inelastic or elastic bandages. Medications that help include aspirin and pentoxifylline. Occasionally skin grafting may be required. Hydrotherapy, Coumadin therapy, and long-term antibiotic therapy are usually not required for venous ulcers.

[folubunmi]

Gracias!

[ryhom]

Excellent