Author Question: The nurse is instructing a patient with a brain tumor about a scheduled craniotomy. What should the ... (Read 71 times)

ahriuashd · **on:** Jun 25, 2018

The nurse is instructing a patient with a brain tumor about a scheduled craniotomy. What should the nurse include in this teaching?

Select all that apply.

1. The tumor is excised.
2. The bone is cut between the burr holes.
3. The bone flap is returned to the opening.
4. A series of burr holes is made in the skull.
5. Plastic material is placed over the opening.

Question 2

While reviewing newly prescribed orders, the nurse begins to prepare a patient to receive plasminogen activator alteplase (tPA). What should the nurse realize about this patient's health problem?

Select all that apply.

1. The patient had an ischemic stroke.
2. The patient had a hemorrhagic stroke.
3. The patient has uncontrollable seizure activity.
4. The patient had a stroke less than 3 hours ago.
5. The patient's systolic blood pressure is greater than 200 mmHg.

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

Answer to Question 1

Correct Answer: 1, 2, 3, 4
A craniotomy is a surgical opening into the cranial cavity. A series of burr holes is made. The bone between the holes is cut. The tumor is excised. The bone flap is returned to the opening. Plastic repair to the skull is done with a cranioplasty.

Answer to Question 2

Correct Answer: 1, 4
Fibrinolytic therapy, using a tissue plasminogen activator such as recombinant tissue-type plasminogen activator alteplase (tPA), is used to treat ischemic stroke. The drug converts plasminogen to plasmin, resulting in fibrinolysis of the clot. To be effective, it must be given IV within 3 hours of the onset of manifestations, after confirming (with a CT scan) that the patient has not had a hemorrhagic stroke. This medication is not used to control seizure activity. If the blood pressure is sustained at systolic levels >185 mmHg, the patient cannot be treated with IV tPA.