Brain attack

Brain attack

NT, 79 year old female arrives to ED at 0705am with expressive aphasia, left facial droop, left sided hemiparesis, mild dysphagia. Husband reports she woke up at 6am, c/o headache and not feeling good. He found her at 0630am having trouble saying words and not moving her left side of body.

Past medical history

• Atrial fibrillation

• HTN

• Hyperlidpemia

• Medications currently taking: warfarin 3 mg daily MWF and 1 mg daily TThSat, ASA 81 mg daily, atorovastatin 40 mg QHS, ibuprofen 200 mg 2 tabs as needed for pain TID, Lisinopril 10 mg PO daily, amiodarone 200 mg PO daily, hormone replacement therapy

Multiple Choice

What diagnostic test is priority?

• NIHSS

• CT scan of head

• MRI of Head

• EKG

CT scan is the priority. The patient could have a hemorrhagic stroke and would not be a candidate for TPA.

Multiple Select

What are her risk factors for CVA?

• hormone replacement therapy

• atrial fibrillation

• hypertension

• hyperlipidemia

Risk factors

• Modifiable (things you can change or manage)

• Non modifiable (things you can not change) age, gender, family history

Open Ended

She has been diagnosed with a thrombotic CVA. What are the criteria for receiving TPA?

Criteria for TPA: chart page 2015

She does meet the criteria. TPA is prepared and dose verified. What are considerations for administering TPA?

Fill in the Blanks

She receives TPA and remains in the ICU for 24 hours. The patient is ordered to receive ASA 325 mg PO this morning. Prior to administering the medication what should the nurse do?

Open Ended

The client has sensory, motor and cognitive deficits post stroke. Identify nursing diagnosis and 3 interventions per diagnosis.

We can discuss in tutoring 😁