Biology Forums - Study Force

Hi! I'm working on the Hesi case study for Brain Attack, and I need help. Here are the questions:


Clinical Manifestations

The Emergency Department (ED) nurse is completing the admission assessment. Nancy is alert but struggles to answer questions. When she attempts to talk, she slurs her speech and appears very frightened.
 
1.
Which additional clinical manifestation(s) should the nurse expect to find if Nancy's symptoms have been caused by a brain attack (stroke)? (Select all that apply.)

    A carotid bruit.
    Elevated blood pressure.
    Hyperreflexic deep tendon reflexes.
    Decreased bowel sounds.
    Difficulty swallowing.

The ED physician has completed an assessment. Gail is sitting at the bedside while the ED nurse continues to assess Nancy every 15 minutes.
2.
Which assessment finding warrants immediate intervention by the nurse?

    Nancy’s Glasgow Coma Scale (GCS) score increases.
    Nancy’s bilateral grip strength is unequal.
    Nancy only responds to painful stimuli.
    Nancy has a negative Babinski's reflex bilaterally.

Thanks!

Post Merge: 10 years ago

Lastly, this one pleas:

Legal Issues

Nancy appears depressed, and Gail reports that her mother seems to have lost all hope. Gail reminds the staff that her mother has a Living Will and a Do Not Resuscitate order. Gail has a Durable Power of Attorney for Health Care that was signed over 2 years ago.

A week later, Gail is sitting at the bedside when Nancy starts to gasp for air. Gail yells for the nurse. When the nurse arrives, Nancy is not breathing. The nurse assesses Nancy's apical pulse but cannot hear anything.
27.
Which intervention should the nurse implement?

    Call a code immediately and reposition Nancy's airway.
    Continue to stay at Nancy's bedside and hold Gail's hand.
    Provide Nancy with 2 rescue breaths and assess the carotid pulse.
    Turn Nancy to the left lateral position and assess the apical heart rate.

I got all the others.

HI monroe025

I think I found the answer to the first question in the attachment I've included.

Check it out :nerd:

Actually fug you! this sh@# didn't help at all!

OK

I'm having the same problem with the case study. Wish I could help

What have you gotten so far, maybe we can build on some ideas.

This one has me stuck as well but the link helped a bit!

1. is A carotid bruit.

I'm having issues with the same one  :( have you by any chance have the answers to the rest of the questions on top of the ones you are looking for?

Okay, the legal one…I'm not going to give the answer, but rather give you a major hint.

If her mother has a DNR in place, are you able to resuscitate her legally?  If she doesn't have an apical pulse, will she have one when you turn her on her side?

Use elimination, and you get your answer!

Post Merge: 10 years ago

Which questions?

All of them  :'( I've done up to question 8 so far and I'm not doing too well. It's for a grade and I have to get at least an 80.

I don't have the questions right off, but if you can post them with the answers I can help!

this link contains all of the questions from the Case Study I am struggling from   :theblues:
 
 http://tegrity.fresnocitycollege.edu/FCC/ec007/Neuro%201/CVA.pdf (http://tegrity.fresnocitycollege.edu/FCC/ec007/Neuro%201/CVA.pdf)

Okay, so here goes some hints…
#3-three of these are associated w/R side brain.
#4-what is the most important thing when you get a CT to ensure a good pic?
#5-CT uses magnets.  Which of these contraindicates use?
#6-can you, the nurse, tell her what happened?
#7-use therapeutic communication.
#8-use conversion
#9-best way to ensure airway
#10-three of these are normal.  Which one is abnormal?
#11-Core nursing!
#12-what is the timeframe for tPA?
#13-which one is life-threatening?
#14-Which one makes sense?
#15-which one cannot be controlled?
#16-she's worried about going through the same thing but she is smoking?  What would you say?
#17-what is homonymous hemianopsia, and how can you help Nancy?
#18-can she use her good side to help her affected side?
#19-what are the limitations of CE?
#20-which one poses the least risk to the pt?
#21-which one details what happened?
#22-which one will help with the joints?
#23-how can she communicate?
#24-which specialty deals with swallowing and talking?
#25-gastric juices might degrade skin.  What can you do to take care of that?
#26-240x2/8=
#27-already done!
#28-think HIPAA.
#29-constraints to donating organs?
#30-what can help the daughter at this time?
#31-again, TC.

If you can't figure them out, let me know which ones.  Good luck!

you are so helpful, i appreciate you so much  :)

I think the legal portion would be that she stay with Gail and hold her hand unless Gail asks her to do otherwise.  Gail can override the Living Will since she has Power of Attorney, but unless she asks you to perform any type of lifesaving technique, you do not perform any.

brain attack answers
1.a
2.c
3.d
4.b
5.c
6.b
7.b
8.d
9.a
10.b
11.d
12.b
13.d
14.a
15.b
16.d
17.b
18.d
19.b
20.a
21.c
22.b
23.d
24.b
25.b
26.c
27.b
28.a
29.c

thank you!

Continue to stay at Nancy's bedside and hold Gail's hand

1. A,b,e
2. c
3. d
4.b
5.c
6.b
7.b
8.66
9. d
10. a
11. a,c,d,e
12. b
13. d
14. b
15. d
16. a
17. b
18.d
19. b
20. d
21. b
22. a
23. c
24. b
25. d
26. b
27. b
28. c
29. b
30. a
31. c

Nancy's Glasglow scale would actually DECREASE if her condition was worsening, not increase.

Thanks so much!

anyone have the answers like with the questions showing because the format for a b c d e changes for everyone . every time you open it

Here are the correct answers (as of 10/30/14). Hope this helps!  ;D

1. A, B, E
2. C
3. D
4. B
5. C
6. B
7. B
8. 66
9. D
10. A
11. A C, D, E
12. B
13. D
14. B
15. D
16. A
17. B
18. D
19. B
20. D
21. B
22. A
23. C
24. B
25. D
26. B
27. B
28. C
29. B
30. A
31. C

Thanks!

Thank you!

Brain Attack (Stroke)

1. ABE
2. C
3. D
4. B
5. C
6. B
7. B
8. 66
9. D
10. A
11. ACDE
12. B
13. D
14. B
15. D
16. A
17. B
18. D
19. B
20. D
21. B
22. A
23. C
24. B
25. D
26. B
27. B
28. C
29. B
30. A
31. C

Maybe I'm looking at a different version of the case study but your "hints" are not helpful at all

Which additional clinical manifestation(s) should the nurse expect to find if Nancy's symptoms have been caused by a brain attack (stroke)? (select all that apply)   

A carotid bruit.
Elevated blood pressure.
Difficulty swallowing.   

Which assessment finding warrants immediate intervention by the nurse?   

Nancy only responds to painful stimuli.   

Which clinical manifestation further supports this assessment?   

Global aphasia.   

Which nursing intervention should the nurse implement when preparing Nancy and her daughter for this procedure?   

Explain to the daughter that her mother will have to remain still throughout the CT scan.   

Which data warrants immediate intervention by the nurse concerning this diagnostic test?   

Right hip replacement.   

Which response is best by the nurse?   

"Your mother has had a stroke, and the blood supply to the brain has been compromised."   

How should the nurse respond?   

"I know this is scary for you. Would you like to sit and talk?"   

Nancy weighs 145 pounds. How many mg of enoxaparin (Lovenox) will the nurse administer? (round to the nearest whole number)   

66.   

With a diagnosis of a brain attack (stroke), which priority intervention should the nurse include in Nancy's plan of care?   

Keep the head of bed elevated.   

Which finding would require immediate intervention by the nurse?   

Nancy's cardiac output is less than 4L/min.   

Which nursing intervention(s) would be priority at this time? (select all that apply)   

Monitor level of consciousness.
Strick intake and output.
Monitor capillary refill every 2-4 hours.
Contact physician.   

How should the nurse respond?   

"She is not a candidate because of therapeutic time constraints related to this medication."   

Which nursing diagnosis has the highest priority?   

Impaired swallowing.   

Which intervention would the nurse implement to address this nursing diagnosis?   

Utilize plate guards when Nancy is eating.   

Which condition is considered a non-modifiable risk factor for a brain attack?   

Advanced age.   

Which statement is warranted in this situation?   

"I should let you know that smoking is a strong risk factor for a brain attack."   

Which nursing intervention would the nurse implement to address this condition?   

Place the objects Nancy needs for activities of daily living on the left side of the table.   

Which intervention should the nurse implement when addressing this condition?   

Instruct Nancy to clasp the right hand with the left hand and raise both hands above the head.   

How should the nurse respond?   

"That procedure is only done with small strokes, not like the one your mom had."   

Which nursing care task should the nurse delegate to the UAP?   

Give Nancy a bed bath and change the bed linens.   

Which written documentation should the nurse put in the client's record?   

PT reported that client became dizzy and was lowered back to the bed with the assistance of a gain belt.   

Which intervention should the nurse implement to prevent joint deformities?   

Place Nancy in a prone position for 15 minutes at least 4 times a day.   

What action should the nurse implement to address this situation?   

Discuss how to use a communication board with both Nancy and her daughter.   

Which rehabilitation team member is responsible for evaluating Nancy's dysphagia.   

The speech therapist.   

Which intervention should the nurse implement while Nancy is receiving tube feedings?   

Cleanse the gastrostomy insertion site with soap and water daily.   

At what rate would the nurse set the infusion pump?   

60mL/hr.   

Which intervention should the nurse implement?   

Continue to stay at Nancy's bedside and hold Gail's hand.   

How should the nurse respond.   

"I am sorry, but I am unable to give you any information."   

Which action should the nurse implement?   

Explain that Nancy can only be a tissue donor, not an organ donor.   

Which action should the nurse implement?   

Notify the chaplain services immediately so the priest can come to the bedside.   

How should the nurse respond?   

"You seem really confused about what to do. Would you like to take about it?"