Neurovascular Disorders and Stroke Nursing Flashcards

Which time window is the FDA-approved limit for IV alteplase (tPA) administration in eligible ischemic stroke patients?

Answer: Within 3 hours of symptom onset (up to 4.5 hours per extended guidelines)

IV alteplase is FDA-approved within 3 hours of ischemic stroke onset, with AHA/ASA extending to 4.5 hours for select patients.

The nurse is preparing a patient for IV tPA. Which finding is an absolute contraindication?

Answer: Active intracranial hemorrhage on CT

Active intracranial hemorrhage on CT is an absolute contraindication to IV tPA due to the risk of worsening hemorrhage.

A patient with ischemic stroke is being monitored post-tPA. The nurse notes the patient's BP is 195/110 mmHg. The priority action is to:

Answer: Administer antihypertensive to keep BP below 180/105 mmHg

Post-tPA guidelines require maintaining BP below 180/105 mmHg to reduce the risk of hemorrhagic transformation.

Which artery occlusion typically produces the syndrome of contralateral hemiplegia, hemisensory loss, homonymous hemianopia, and aphasia (dominant hemisphere)?

Answer: Middle cerebral artery

Middle cerebral artery (MCA) occlusion produces contralateral hemiplegia, hemisensory loss, hemianopia, and aphasia if the dominant hemisphere is affected.

The nurse is caring for a patient with a hemorrhagic stroke on anticoagulation. Which medication is used to reverse warfarin toxicity emergently?

Answer: 4-factor prothrombin complex concentrate (4F-PCC)

4-factor prothrombin complex concentrate (4F-PCC) provides rapid, complete reversal of warfarin anticoagulation in hemorrhagic emergencies.

Which neurological deficit is most characteristic of a cerebellar stroke?

Answer: Ipsilateral limb ataxia and gait instability

Cerebellar stroke produces ipsilateral limb ataxia, nystagmus, dysarthria, and gait instability due to incoordination of the ipsilateral side.