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The nurse is preparing health education for a patient who is being discharged after hospitalization for a hemorrhagic stroke. What content should the nurse include in this education?
- A. Mild, intermittent seizures can be expected.
- B. Take ibuprofen for complaints of a serious headache.
- C. Take antihypertensive medication as ordered.
- D. Drowsiness is normal for the first week after discharge.
Correct Answer: C
Rationale: Antihypertensive therapy is critical to manage hypertension, a key risk factor for hemorrhagic stroke. Seizures, ibuprofen use, and drowsiness are not normal or advised.
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The nurse is performing stroke risk screenings at a hospital open house. The nurse has identified four patients who might be at risk for a stroke. Which patient is likely at the highest risk for a hemorrhagic stroke?
- A. White female, age 60, with history of excessive alcohol intake
- B. White male, age 60, with history of uncontrolled hypertension
- C. Black male, age 60, with history of diabetes
- D. Black male, age 50, with history of smoking
Correct Answer: B
Rationale: Uncontrolled hypertension is the primary risk factor for hemorrhagic stroke. Alcohol, diabetes, and smoking increase risk but are less significant than hypertension.
The nurse is caring for a patient diagnosed with an ischemic stroke and knows that effective positioning of the patient is important. Which of the following should be integrated into the patients plan of care?
- A. The patients hip joint should be maintained in a flexed position.
- B. The patient should be in a supine position unless ambulating.
- C. The patient should be placed in a prone position for 15 to 30 minutes several times a day.
- D. The patient should be placed in a Trendelenberg position two to three times daily to promote cerebral perfusion.
Correct Answer: C
Rationale: Prone positioning with pelvic support promotes hip extension, preventing contractures. Flexed hips, supine-only positioning, and Trendelenberg are inappropriate.
When caring for a patient who had a hemorrhagic stroke, close monitoring of vital signs and neurologic changes is imperative. What is the earliest sign of deterioration in a patient with a hemorrhagic stroke of which the nurse should be aware?
- A. Generalized pain
- B. Alteration in level of consciousness (LOC)
- C. Tonicclonic seizures
- D. Shortness of breath
Correct Answer: B
Rationale: Altered LOC, such as drowsiness or slurred speech, is the earliest sign of deterioration in hemorrhagic stroke. Pain, seizures, and shortness of breath are not typical early signs.
A patient has had an ischemic stroke and has been admitted to the medical unit. What action should the nurse perform to best prevent joint deformities?
- A. Place the patient in the prone position for 30 minutes/day.
- B. Assist the patient in acutely flexing the thigh to promote movement.
- C. Place a pillow in the axilla when there is limited external rotation.
- D. Place patients hand in pronation.
Correct Answer: C
Rationale: A pillow in the axilla prevents shoulder adduction, reducing deformity risk. Prone positioning aids hip extension, not daily for 30 minutes. Acute thigh flexion may cause edema, and hand pronation is less functional than supination.
A patient diagnosed with a hemorrhagic stroke has been admitted to the neurologic ICU. The nurse knows that teaching for the patient and family needs to begin as soon as the patient is settled on the unit and will continue until the patient is discharged. What will family education need to include?
- A. How to differentiate between hemorrhagic and ischemic stroke
- B. Risk factors for ischemic stroke
- C. How to correctly modify the home environment
- D. Techniques for adjusting the patients medication dosages at home
Correct Answer: C
Rationale: Home environment modifications support the patient's disability needs post-stroke. Stroke differentiation and medication adjustments are not family responsibilities.