PCU Neurological & Renal Care Flashcards

A PCU patient with altered mental status has a Glasgow Coma Scale (GCS) score of 10. Which component scores are being assessed?

Answer: Eye opening, verbal response, motor response

The GCS assesses eye opening, verbal response, and motor response, with a maximum score of 15 and minimum of 3.

A PCU patient develops sudden-onset severe headache, neck stiffness, and photophobia. What condition should the nurse suspect first?

Answer: Subarachnoid hemorrhage

Sudden severe 'thunderclap' headache with meningeal signs in a PCU patient is a classic presentation of subarachnoid hemorrhage until proven otherwise.

Which neurological assessment finding requires IMMEDIATE physician notification in a PCU patient?

Answer: Unequal pupil size (anisocoria) with decreased responsiveness

Unequal pupils with decreased responsiveness indicate possible herniation or increased intracranial pressure and require immediate intervention.

A PCU patient has a serum creatinine of 3.8 mg/dL and BUN of 58 mg/dL. What nursing priority is most appropriate?

Answer: Review and hold nephrotoxic medications pending physician review

Elevated creatinine and BUN indicate impaired renal function; the nurse should identify and hold nephrotoxic agents and notify the physician.

Which urine output value over 8 hours most indicates acute kidney injury (AKI) in a PCU patient weighing 70 kg?

Answer: 150 mL

Oliguria in AKI is defined as less than 0.5 mL/kg/hr; for a 70 kg patient over 8 hours, this threshold is 280 mL, so 150 mL is severely below normal.

A PCU patient receiving IV contrast for a CT scan has a creatinine of 2.1 mg/dL. Which pre-procedure intervention is most important?

Answer: Provide IV hydration with normal saline to protect renal function

IV hydration with isotonic saline before and after contrast administration reduces the risk of contrast-induced nephropathy in patients with pre-existing renal impairment.