FlashKeepers

Nursing · NCLEX-RN

Neurological Nursing: Assessment and Care

Stroke, seizure, and increased intracranial pressure nursing assessment priorities on the medical-surgical floor, distinct from the ICU neuro-monitoring deck.

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What does the FAST acronym assess for in suspected stroke?
Face drooping, Arm weakness, Speech difficulty, Time to call for help
What is the standard time window for giving tPA after ischemic stroke symptom onset?
Within 3 to 4.5 hours of symptom onset
What is the priority nursing assessment for a patient with sudden neurological symptoms?
Airway, breathing, and circulation, followed by a neurologic assessment
What causes an ischemic stroke?
A blood clot blocking blood flow to part of the brain
What causes a hemorrhagic stroke?
Bleeding into or around brain tissue from a ruptured blood vessel
Why must a CT scan be done before giving tPA?
To rule out hemorrhagic stroke, since tPA can worsen bleeding
What should a nurse do before giving a stroke patient anything by mouth?
Perform a swallow screening to check for dysphagia
What position reduces aspiration risk during a stroke patient's swallow evaluation?
Upright sitting position (high Fowler's)
Why is blood pressure typically allowed to run higher than normal right after an acute ischemic stroke?
To maintain cerebral perfusion to the at-risk brain tissue (permissive hypertension)
If a stroke damages the left side of the brain, which side of the body is typically weak?
The right side of the body
What is expressive aphasia?
Difficulty producing or forming speech despite understanding language
What is receptive aphasia?
Difficulty understanding spoken or written language
What is the first nursing priority when a patient begins having a seizure?
Protect the patient from injury and maintain a patent airway
During a seizure, why should a nurse never restrain a patient's movements?
Restraining can cause fractures or other injuries
During a seizure, why should a nurse never place anything in the patient's mouth?
It can cause airway obstruction or injury to the teeth and mouth

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