Question 1

Complications associated with craniotomy include

Accepted Answer

Complications associated with a craniotomy include intracranial hypertension,surgical hemorrhage,fluid imbalance,cerebrospinal fluid leak,and deep venous thrombosis.

Question 2

The patient has sustained an ischemic stroke involving the left cerebral hemisphere.Which of the following neurologic abnormalities would you expect to see?

Accepted Answer

With strokes in the left (dominant)hemisphere,patients may have aphasia; right hemiparesis; right-sided sensory loss; right visual field defect; poor right conjugate gaze; dysarthria; and difficulty in reading,writing,or calculating.With strokes in the right (nondominant)hemisphere,patients may have neglect of the left visual space,left visual field defect,left hemiparesis,left-sided sensory loss,poor left conjugate gaze,extinction of left-sided stimuli,dysarthria,and spatial disorientation.With strokes in the brainstem,cerebellum,and posterior hemisphere,patients may have motor or sensory loss in all four limbs,crossed signs,limb or gait ataxia,dysarthria,disconjugate gaze,nystagmus,amnesia,and bilateral visual field defects.

Question 3

A patient has been admitted with an ischemic stroke.The patient received recombinant tissue plasminogen activator (rtPA)in the emergency department.The nurse checks the medication administration record to make sure the patient does not have which medications for the next 24 hours?

Accepted Answer

The major risk and complication of rtPA therapy is bleeding,especially intracranial hemorrhage.Unlike fibrinolytic protocols for acute myocardial infarction,subsequent therapy with anticoagulant or antiplatelet agents is not recommended after rtPA administration in ischemic stroke.Patients receiving fibrinolytic therapy for stroke should not receive aspirin,heparin,warfarin,ticlopidine,or any other antithrombotic or antiplatelet drugs for at least 24 hours after treatment.Sodium nitroprusside and labetalol are used to manage blood pressure after a stroke.

Question 4

Nonencapsulated tumors tend to infiltrate brain tissue.These tumors can arise in any part of brain connective tissue and infiltrate primarily cerebral hemisphere tissue.These tumors grow rapidly and are difficult to excise completely.The tumors described are classified as

Accepted Answer

Gliomas are nonencapsulated; tend to infiltrate brain tissue; arise in any part of brain connective tissue; infiltrate primarily cerebral hemisphere tissue; are not well outlined,so they are difficult to excise completely; and grow rapidly.Most persons live months to years after diagnosis.Tumors are assigned grade from I to IV,with IV being most malignant.Angiomas arise from vascular structures and are usually difficult to resect.Pituitary adenomas arise from various tissues.A surgical approach is usually successful,and recurrence is possible.Meningiomas arise from meningeal coverings of brain.They are usually benign but may undergo malignant changes.They are usually encapsulated.Surgical cure is possible but so is recurrence.

Quiz 24: Neurologic Disorders and Therapeutic Management

Complications associated with craniotomy include

The patient has sustained an ischemic stroke involving the left cerebral hemisphere.Which of the following neurologic abnormalities would you expect to see?

A patient has been admitted with an ischemic stroke.The patient received recombinant tissue plasminogen activator (rtPA) in the emergency department.The nurse checks the medication administration record to make sure the patient does not have which medications for the next 24 hours?

Nonencapsulated tumors tend to infiltrate brain tissue.These tumors can arise in any part of brain connective tissue and infiltrate primarily cerebral hemisphere tissue.These tumors grow rapidly and are difficult to excise completely.The tumors described are classified as