đźš© Red Flag or Expected?
A patient with Parkinson’s disease has a shuffling gait and slow movement. Red flag or expected?
Expected — bradykinesia and mobility changes are characteristic of Parkinson’s disease. Bradykinesia, rigidity, tremor, and postural instability are the four cardinal manifestations.
Blood flow to an area of the brain is temporarily interrupted but returns before permanent infarction occurs. What neurologic event has occurred?
TIA.
Which patient should the nurse see first?
A. Parkinson’s patient who needs help eating
B. Alzheimer’s patient asking the same question repeatedly
C. Patient reporting sudden facial droop
D. Patient with chronic hearing loss who cannot find a hearing aid
C — sudden facial droop.
Why: A new focal neurologic deficit may indicate acute stroke.
A patient with severe vertigo is admitted to the unit. What complication should the nurse work hardest to prevent?
Falls/injury.
I cause a feeling that you or your surroundings are spinning. What am I?
Vertigo
A patient with early Alzheimer’s disease frequently misplaces items and has difficulty remembering newly learned information. Red flag or expected?
Expected — short-term memory impairment and difficulty recalling new information occur early in Alzheimer’s disease
An artery supplying the brain becomes blocked. What happens to the brain tissue downstream from the obstruction?
Decreased perfusion causes ischemia; if blood flow is not restored, brain cells infarct and die.
Which patient should the nurse see first?
A. Patient with Ménière disease reporting tinnitus
B. Patient with glaucoma asking about medications
C. Stroke patient coughing after attempting to drink water
D. Alzheimer’s patient wandering in the hallway with staff supervision
C — the stroke patient coughing after drinking.
Why: Dysphagia can compromise airway protection and increase aspiration risk.
A patient with Parkinson’s has slow movement and postural instability. What nursing intervention helps prevent a common complication?
Assist with safe mobility and implement fall precautions.
Tinnitus + vertigo + one-sided sensorineural hearing loss = ?
Ménière disease
A patient with a history of migraines suddenly develops the worst headache of their life. Red flag or expected?
Red flag — a sudden severe headache requires evaluation for an acute neurologic problem rather than assuming it is the patient's usual migraine.
A cerebral blood vessel ruptures. Why can neurologic function deteriorate even beyond the tissue directly affected by the bleeding?
Bleeding can cause edema and pressure on surrounding brain tissue.
Which patient requires the most immediate intervention?
A. Parkinson’s patient with a shuffling gait
B. Patient with gradual age-related hearing loss
C. Patient with migraine requesting a darkened room
D. Patient who suddenly cannot understand what the nurse is saying
D.
Why: Sudden receptive aphasia can represent an acute neurologic deficit.
A patient has significant hearing loss. What should the nurse change before providing important discharge instructions?
Reduce background noise, face the patient, and ensure the patient can see and hear the nurse clearly. Your source specifically recommends a quiet environment, facing the patient, and speaking slowly and clearly.
The patient knows what they want to say and understands your question but cannot get the words out. What neurologic deficit are you seeing?
Expressive/Broca aphasia.
A patient recovering from a stroke suddenly develops new weakness that was not present an hour ago. Red flag or expected?
Red flag — any new or worsening neurologic deficit requires immediate evaluation.
A patient with Parkinson’s disease has increasing difficulty initiating movement. What underlying neurologic problem contributes to this finding?
Loss of dopamine activity disrupts normal control of movement.
The nurse receives four reports. Who should be assessed first?
A. Alzheimer’s patient increasingly dependent with ADLs over several months
B. Parkinson’s patient with chronic rigidity
C. Stroke patient whose LOC has decreased since the previous neuro check
D. Patient with cataracts reporting progressively blurred vision
C — the patient with decreasing LOC.
Why: A change in neurologic status can indicate deterioration and requires immediate assessment.
A patient with moderate Alzheimer’s frequently wanders. What should guide the nursing plan?
Maintain a safe environment while allowing as much safe independence and mobility as possible.
A patient has atrial fibrillation and suddenly develops a neurologic deficit. Explain the pathophysiologic connection.
A thrombus can form in the heart, dislodge, travel to a cerebral artery, and obstruct cerebral blood flow, causing an embolic ischemic stroke.
A patient with Alzheimer’s who is normally pleasantly confused suddenly becomes extremely agitated, inattentive, and much more confused. Red flag or expected progression?
Red flag — the acute change should prompt assessment for delirium or another new problem rather than automatically attributing it to dementia.
In Alzheimer’s disease, neurofibrillary tangles containing abnormal tau and plaques containing beta amyloid develop. What is the important functional consequence?
Neuronal transmission becomes impaired, contributing to progressive loss of cognition and memory. Pasted text (3)
A patient admitted after a stroke was alert with stable deficits 30 minutes ago. The nurse now finds the patient difficult to arouse. What should the nurse do first?
Immediately assess the patient and initiate an urgent response to the neurologic deterioration.
Key idea: Don't wait for the next scheduled neuro check.
A patient who had a TIA asks what can be done to decrease the chance of a future stroke. Name three modifiable areas the nurse should reinforce.
Examples include controlling hypertension, managing diabetes, smoking cessation, healthy diet, increased physical activity, and taking prescribed antiplatelet therapy. Pasted text (4)
A patient suddenly develops right-sided weakness and difficulty speaking. The family says symptoms began 45 minutes ago.
The patient asks for water while waiting for evaluation.
Give me THREE things the nurse should recognize or do based on these findings.