Neuro Meds
A patient who had a TIA is prescribed aspirin. What is the purpose of this medication?
To decrease platelet aggregation and reduce the risk of thrombotic or embolic stroke.
What standardized assessment tool is commonly used to measure neurologic deficits in a patient with suspected stroke?
NIH Stroke Scale (NIHSS)
A patient reports cloudy or blurry vision that has gradually worsened because the normally clear lens has become opaque. What disorder should the nurse suspect?
Cataract
Cerumen completely blocks a patient's ear canal. What type of hearing loss can result?
Conductive hearing loss
A patient who recently had a stroke asks for water. What should the nurse verify before allowing the patient to drink?
That swallowing ability has been assessed and it is safe for the patient to take oral fluids.
A patient asks why clopidogrel was prescribed after a TIA. What is the nurse's best explanation?
It decreases the ability of platelets to stick together, helping prevent formation of a clot that could cause a stroke.
What three areas of patient response are evaluated when determining a Glasgow Coma Scale score?
Eye opening, verbal response, and motor response
A patient has increased intraocular pressure that can eventually damage the optic nerve. What disorder is the nurse concerned about?
Glaucoma
Damage to the cochlea or cranial nerve VIII causes what type of hearing loss?
Sensorineural hearing loss
A patient with Parkinson’s has a shuffling gait and difficulty initiating movement. What nursing concern should receive increased attention?
Fall prevention and safe mobility.
A patient with Parkinson’s disease receives medication intended to improve dopamine activity. Why does increasing dopamine activity improve the patient's movement?
Parkinson’s disease involves decreased dopamine activity, which contributes to impaired control of movement.
Why is a noncontrast CT of the head typically performed early when a patient presents with stroke symptoms?
To identify bleeding and help differentiate hemorrhagic from ischemic stroke.
Why is untreated glaucoma particularly concerning even when the patient is not experiencing significant pain?
Progressive optic nerve damage can cause permanent vision loss
A patient reports tinnitus, vertigo, and one-sided sensorineural hearing loss. What disorder should the nurse suspect?
Ménière disease.
A patient with Alzheimer’s repeatedly says, “I need to go home and pick up my children,” although the children are now adults. What should guide the nurse's response?
Acknowledge the patient's feelings rather than arguing about the inaccurate statement.
A patient taking medication for Parkinson’s says, “My medication works well at first, but my symptoms return before my next dose.” What should the nurse recognize?
The patient may be experiencing fluctuations in the effectiveness of Parkinson’s medication and the finding should be reported/evaluated.
A patient's Glasgow Coma Scale was 15 earlier in the shift and is now 12. Which is more important to the nurse: the actual score of 12 or the change from the previous assessment?
The change from baseline is especially important because a decreasing GCS indicates neurologic deterioration.
A patient suddenly reports flashes of light, new floaters, and a curtain-like shadow over the visual field. What should the nurse recognize?
Possible retinal detachment requiring prompt evaluation
A hospitalized older adult has hearing loss. The nurse needs to provide discharge teaching. What communication approach is most appropriate?
Reduce background noise, face the patient, and speak slowly and clearly in a deeper voice rather than shouting.
A patient who had a TIA says, “The weakness went away, so nothing was really wrong.” What is the most important teaching?
A TIA is caused by temporary interruption of cerebral blood flow and can be a warning sign for a future stroke; symptoms require urgent evaluation.
A patient being evaluated for an acute stroke asks why the nurse cannot simply give a clot-busting medication immediately. What must first be determined?
Whether the stroke is ischemic or hemorrhagic and whether the patient meets criteria for thrombolytic treatment.
A patient has sudden neurologic symptoms. The initial head CT does not identify the cause, and further evaluation of cerebral and carotid circulation is needed. What types of vascular imaging might be ordered?
CTA or MRA of the brain and neck.
A visually impaired hospitalized patient is unfamiliar with the room. What nursing intervention promotes both independence and safety?
Orient the patient to the environment and keep commonly used objects in consistent, predictable locations.
A patient with severe vertigo from an inner-ear disorder attempts to walk independently to the bathroom. What is the nurse's priority concern?
Fall/injury prevention related to impaired balance.
The nurse has four patients. Which should be assessed first?
A. Patient with Parkinson’s who needs assistance getting to the bathroom
B. Patient with Alzheimer’s who is repeatedly asking what day it is
C. Patient with a history of migraine requesting medication for a typical headache
D. Patient who suddenly developed difficulty speaking and right-arm weakness
D — the patient with sudden difficulty speaking and right-arm weakness.
Why: These are new focal neurologic deficits consistent with possible acute stroke. Rapid recognition and intervention are the priority.