PCU Neurological & Renal Care Flashcards

A PCU patient post-craniotomy has clear drainage from the nose. Which action should the nurse take first?

Answer: Test the fluid for glucose using a reagent strip

Clear nasal drainage after craniotomy may represent CSF leak; testing for glucose (CSF contains glucose, nasal mucus does not at significant levels) helps identify CSF rhinorrhea.

What is the target mean arterial pressure (MAP) range most commonly used in PCU patients following ischemic stroke to maintain cerebral perfusion?

Answer: ≥65 mmHg (individualized per protocol)

A MAP ≥65 mmHg is a common minimum target, but post-stroke protocols often individualize targets higher (e.g., 70–90 mmHg) to maintain cerebral perfusion pressure.

A PCU patient with acute kidney injury has a phosphorus level of 6.8 mg/dL. Which dietary restriction is most appropriate?

Answer: Phosphorus-restricted diet

Hyperphosphatemia in AKI is managed with phosphorus restriction and phosphate binders, as impaired kidneys cannot excrete excess phosphorus.

Which sign or symptom differentiates neurogenic shock from hypovolemic shock in a PCU patient?

Answer: Warm, dry skin with bradycardia

Neurogenic shock causes loss of sympathetic tone, resulting in vasodilation (warm, dry skin) and bradycardia, unlike hypovolemic shock which causes vasoconstriction and tachycardia.

A PCU patient's urine dipstick shows 3+ protein. Which condition does this finding most suggest?

Answer: Nephrotic syndrome or significant glomerular damage

Significant proteinuria (3+) indicates glomerular damage or nephrotic syndrome, as healthy kidneys retain most protein and do not filter it into urine in large amounts.

What is the most important nursing intervention to prevent ventilator-associated pneumonia (VAP) in a PCU patient who is intubated?

Answer: Maintain head of bed elevation at 30–45 degrees

Elevating the head of bed 30–45 degrees reduces aspiration of oropharyngeal secretions and is a core VAP prevention bundle element.