Neurovascular Disorders and Stroke Nursing Flashcards

Vasospasm after subarachnoid hemorrhage peaks at which time frame following the initial bleed?

Answer: Days 4–14 (peak days 7–10)

Cerebral vasospasm after SAH typically occurs between days 4–14, with the highest incidence around days 7–10.

Which medication regimen is standard to reduce vasospasm-related ischemia after subarachnoid hemorrhage?

Answer: Nimodipine 60 mg orally every 4 hours for 21 days

Nimodipine 60 mg orally every 4 hours for 21 days is the evidence-based standard to reduce vasospasm-related cerebral ischemia after SAH.

A patient with SAH develops delayed cerebral ischemia. The nurse implements 'Triple-H therapy.' This refers to:

Answer: Hypertension, hypervolemia, hemodilution

Triple-H therapy (hypertension, hypervolemia, hemodilution) aims to increase cerebral perfusion in vasospasm-related delayed ischemia.

A patient presents with sudden onset of diplopia, dysphagia, ataxia, and ipsilateral facial numbness with contralateral body numbness. The nurse recognizes this as:

Answer: Wallenberg (lateral medullary) syndrome

Wallenberg syndrome (lateral medullary infarction) presents with ipsilateral facial sensory loss, contralateral body sensory loss, dysphagia, hoarseness, and ataxia.

Which stroke scale is used at the bedside by nurses to quantify stroke severity and guide acute treatment decisions?

Answer: NIH Stroke Scale (NIHSS)

The NIH Stroke Scale (NIHSS) is the standardized bedside tool used to quantify acute stroke severity across 15 neurological domains.

A patient develops worsening headache, confusion, and right-sided weakness 24 hours after a craniotomy for AVM resection. The most likely complication is:

Answer: Normal perfusion pressure breakthrough bleeding

Normal perfusion pressure breakthrough (NPPB) hemorrhage occurs when chronically hypoperfused vessels cannot autoregulate after AVM removal.