vg1003

in the one labeled 14 above, the choices are c, e, b, or h -> answer is b-- stroke on one side of the brain causes motor symptoms on the contralateral (opposite) side of the body, and god help you if the neurosurgeon finds out you gave an anticoagulant to somebody with an active brain bleed. since you don't use an anticoagulant would you raise the head of the patient's bed and about 30 degrees to minimize increased cranial pressure? in the one labeled 13 above, the choices are d, e, g, or h -> answer is d-- e is still wrong, g is wrong, and you still had better not anticoagulate this babe in the one labeled 15 above, the choices are h, g, c, or i -> answer is i; it's a weird syndrome, but that's what happens. g, h, and c are still wrong. how do you keep straight which side of the upper and lower body are effected? also, do i have the answer to number 12 correct?

Can anyone verify the answers I have chosen? I keep going back and forth with my answers and it's driving me nuts. Here is what I came up with. If one or more does happen to be incorrect can you guys let me know why so maybe I can understand this information better. Plus, nobody wants to make these mistakes in real life nursing. Thanks all 12.A 13.B 14.B 15.A ***Questions 12-15 refer to the following patient: A 28-year-old woman with a history of severe HTN presents to the ER with certain S&S that are consistent with brain attack (stroke). A CAT scan shows bleeding in one hemisphere of the cerebrum. 12. Which single answer reflects the most accurate possible set of S&S ? a. The patient is unable to talk and also unable to smile on the right side of her face. b. Left-sided neglect is evident when the patient denies the presence of people standing on her left side. c. Right-sided neglect is evident when the patient denies the presence of people standing on her left side. d. The patient’s right pupil does not react to light and she has hemiparesis of the right arm and leg. List for questions 13, 14, & 15: A. The bleeding in the brain is likely caused by the high cerebral perfusion pressure of her hypertension. B. The bleeding caused irritation of the brain, inflaming the area and causing edema to press pathologically on certain corticospinal tracts that control the contralateral side of the body below the shoulders. C. If the bleeding is in the left hemisphere, the patient is likely to have left-sided neglect related to impairment of spatiality. D. Sensorimotor changes above the shoulders reflect impairment that is ipsilateral to the brain hemisphere that has bleeding. E. The bleeding caused irritation of the brain, inflaming the area and causing edema to press pathologically on certain corticospinal tracts that control the ipsilateral side of the body below the shoulders. F. Interventions for this patient should include raising the head of the bed to about 30 degrees to minimize increased ICP. G. Sensorimotor changes above the shoulders reflect impairment that is contralateral to the brain hemisphere that has bleeding. H. Interventions for this patient should include an anticoagulant to prevent pathological clotting in the areas of cerebral bleeding. I. If the bleeding is in the right hemisphere, the patient is likely to deny that she has any illness or impairment at all. In each of questions 13,14, & 15, choose the answer that accurately reflects the relationship between patho, causes, S&S, and/or interventions in regards to the scenario above. [TABLE=width: 100%] [TR] [TD]14. a. C b. E c. B d. H [/TD] [/TR] [/TABLE] [TABLE=width: 100%] [TR] [TD]13. a. D b. E c. G d. H [/TD] [/TR] [/TABLE] [TABLE=width: 100%] [TR] [TD]15. a. H b. G c. C d. I [/TD] [/TR] [/TABLE]

Kel, You explained the blood compatibility so clearly and thoroughly that it FINALLY makes sense!!! Thank you so much for your help. I will nail any questions we have in regards to this topic on our next test! YAY!!! Sorry, I'm super excited. It's just nice when something finally clicks and you understand something that was frustrating and difficult to understand. vg1003

Which of the following compatibility situations is most likely? A patient who is a. B positive and receives B negative blood will have a transfusion reaction. b. AB positive and receives B negative blood will do fine. c. A negative and receives A positive blood will do fine. d. A negative and receives O negative blood will have a transfusion reaction.

Which of the following compatibility situations is most likely? A patient who is a. B positive and receives B negative blood will have a transfusion reaction. b. AB positive and receives B negative blood will do fine. c. A negative and receives A positive blood will do fine. d. A negative and receives O negative blood will have a transfusion reaction.

Thanks Scott!!! 5. A patient is hospitalized in renal failure. Because of her kidneys’ inability to excrete water, she has generalized edema & a serum sodium of 129. Because the kidneys have also lost the ability to appropriately regulate potassium, she also has a serum potassium of 5.9. These lab results show: a. hypernatremia & hypokalemia. b. hyperkalemia & hyponatremia. c. hyperosmolality & hypernatremia. d. hypoosmolality & hypocalcemia. I chose answer b for this one. 6. In the previous question, the edema is most likely due to fluid shifting from the intravascular space into interstitial spaces secondary to all the following EXCEPT: a. hypertonicity of the plasma space. b. hypotonicity of the plasma space. c. hypoosmolality of the blood. d. diminished osmotic pressure of the blood. I chose a. (hopefully the right answer) Can I get some detail on this, please?

To go along with that question. All of the following are accurate possible findings in the patient above EXCEPT a. that he has confusion due swollen brain cells. b. that he has crackles in his lungs from fluid in the alveoli (lung tissue). c. that his serum osmolality is 302 (norm = 280- 295). d. that he will need a hypertonic IV solution to return fluid status to normal. I'm having a hard time getting to the correct answer because I believe the answer is either c or d but they both seem plausible. Can anyone tell me which one and why so I can understand better?

A patient with cancer who can't eat and has lost 80 pounds. Let's add to his assessment findings: let's say he has generalized edema and a serum protein of 4gm/dl (normal = 6.0 to 8.3 gm/dl ). Which is the most accurate mini-concept map linking low protein with edema? a. hypoproteinemia - concentration in blood is now lower than the normal concentration of fluids inside cellsà fluid goes from B to T. b. hypoproteinemia - concentration in blood is now higher than the normal concentration of fluids inside cellsà fluid goes from B to T c. hypoproteinemia- blood is now hyperosmolar compared to the cells à fluid goes from T to B d. hyperproteinemia -blood now has lower oncotic pressure than normalà fluid goes from T to B I chose answer A. Is this correct?

Assuming I have not gone into the patient's room I would check the chart and see what has been done to the gentleman so far that day. I would look for problems other nurses have noted and whether there has been new information on the patient. Upon walking into the room I would assess the patient. "What is happening to this patient?" I would carefully observe the patient and see whether the patient was conscious. If so, I would try to figure out why he's taking off his gown. I would talk to the patient and see if he was hot or itchy, feeling uncomfortable or having any pain. I would also ask whether the treatment or medication was helping and if there was anything I could do to make him feel more comfortable then note whatever he tells me. Then, I would try to check all the equipment in the room like making sure the intravenous line is open and the correct solution is flowing at the correct rate. Next, I would make sure the patient's environment is clean and safe. Then I would take their vital signs and make sure the patient is comfortable. My solution after this would be ???? Record the patient's status and nursing care and lastly evaluate the care given.

If there is one thing I learned about critical thinking it was that it is developed through having discussions with other nurses. I guess I was wrong.

Scenario