nursing considerations in neurological care Flashcards

1
Q

what is pneumbra?

A
  • area that could be affected by stroke
  • nurses should try at all costs to save cells around primary injury
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2
Q

how do nurses limit pneumbra?

A
  • early stroke consultant assessment: odds of death low at 30 days
  • CT scan within 24 hours
  • early nurse and therapist assessment
  • early swallow assessment and nutrition management
  • early IV fluids and aspirin
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3
Q

what are essential nursing interventions in acute stroke care?

A
  • positioning: seated upright
  • GCS
  • BM
  • BP: treat if BP >180/100
  • sats <95%
  • temp
  • swallowing screening
  • hydration and nutrition
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4
Q

how do nurses prevent aspiration?

A
  • positioning of head of bed (at least 30 degrees)
  • suction setup
  • residual neurological symptoms remain NPO until dysphagia screening
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5
Q

why do nurses need to keep the blood glucose controlled?

A
  • risk of diabetics
  • acute hyperglycemia at time of stroke
  • should monitor on admission
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6
Q

why do nurses need to consider temperature?

A
  • fever could have critical effect in first 24hrs after stroke
  • goal - afebrile
  • 37.5 - treat aggressively physical and pharmacologically
  • prevent shivering
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