Acute Care Flashcards

A stroke patient with dysphagia fails a bedside swallow screen. Which nutritional strategy is most appropriate for the short term?

Answer: Nasogastric (NG) tube feeding

Nasogastric tube feeding is the first-line enteral route for short-term nutritional support in stroke patients who fail dysphagia screening.

A patient with acute ischemic stroke has a serum sodium of 126 mEq/L on day 3. The most likely cause in the stroke population is:

Answer: Syndrome of inappropriate antidiuretic hormone secretion (SIADH)

SIADH is the most common cause of hyponatremia following stroke due to inappropriate ADH release from hypothalamic disruption.

Which assessment finding indicates successful reperfusion after mechanical thrombectomy?

Answer: Improvement in neurological deficits and TICI 2b/3 reperfusion on angiogram

Successful reperfusion is defined angiographically as TICI grade 2b or 3 and clinically as improvement in neurological deficits.

A patient admitted with ischemic stroke has an LDL of 145 mg/dL. Per current stroke guidelines, what medication should be started during the acute hospitalization?

Answer: High-intensity statin therapy

High-intensity statin therapy reduces recurrent stroke and cardiovascular events and should be initiated during acute hospitalization regardless of baseline LDL.

During the first 24 hours after IV alteplase, a patient's blood pressure must be maintained below which threshold?

Answer: 180/105 mmHg

After alteplase administration, blood pressure must be kept below 180/105 mmHg for at least 24 hours to minimize the risk of hemorrhagic transformation.

A stroke patient is being discharged on apixaban for newly diagnosed atrial fibrillation. The SCRN's education should emphasize which critical point?

Answer: Never miss a dose, avoid NSAIDs, and report unusual bleeding immediately

Consistent dosing adherence, avoidance of NSAIDs that increase bleeding risk, and prompt reporting of bleeding signs are essential for safe DOAC therapy.

A patient is transferred from the ICU to the stroke unit 48 hours after a large MCA infarct. Which complication requires ongoing prophylactic nursing intervention throughout hospitalization?

Answer: Deep vein thrombosis (DVT)

Immobility after stroke significantly increases DVT risk; prophylaxis with compression devices and pharmacological anticoagulation (when safe) must be maintained throughout the hospital stay.