Author Question: A patient with carotid atherosclerosis asks the nurse to describe a carotid endarterectomy. Which ... (Read 225 times)

WWatsford · **on:** Jun 25, 2018

A patient with carotid atherosclerosis asks the nurse to describe a carotid endarterectomy. Which response by the nurse is accurate?

a. The obstructing plaque is surgically removed from an artery in the neck.
b. The diseased portion of the artery in the brain is replaced with a synthetic graft.
c. A wire is threaded through an artery in the leg to the clots in the carotid artery and the clots are removed.
d. A catheter with a deflated balloon is positioned at the narrow area, and the balloon is inflated to flatten the plaque.

Question 2

A 56-year-old patient arrives in the emergency department with hemiparesis and dysarthria that started 2 hours previously, and health records show a history of several transient ischemic attacks (TIAs). The nurse anticipates preparing the patient for

a. surgical endarterectomy.
b. transluminal angioplasty.
c. intravenous heparin administration.
d. tissue plasminogen activator (tPA) infusion.

millet · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

ANS: A
In a carotid endarterectomy, the carotid artery is incised and the plaque is removed. The response beginning, The diseased portion of the artery in the brain is replaced describes an arterial graft procedure. The answer beginning, A catheter with a deflated balloon is positioned at the narrow area describes an angioplasty. The final response beginning, A wire is threaded through the artery describes the mechanical embolus removal in cerebral ischemia (MERCI) procedure.

Answer to Question 2

ANS: D
The patient's history and clinical manifestations suggest an acute ischemic stroke and a patient who is seen within 4.5 hours of stroke onset is likely to receive tPA (after screening with a CT scan). Heparin administration in the emergency phase is not indicated. Emergent carotid transluminal angioplasty or endarterectomy is not indicated for the patient who is having an acute ischemic stroke.