Mixed Deck — All SCRN Topics Flashcards

What is the significance of nutrition in post-acute stroke care?

Answer: It supports brain recovery and overall health

Optimal nutrition is crucial in post-acute stroke care because it directly supports the brain's recovery processes and the body's overall healing. Adequate nutrients are essential for neuroplasticity, reducing inflammation, and preventing complications like malnutrition, which can significantly hinder rehabilitation progress. Therefore, a well-managed nutritional plan plays a vital role in improving patient outcomes and accelerating recovery after a stroke.

What is a key consideration in post-acute stroke care for elderly patients?

Answer: Address both stroke recovery and age-related health issues

For elderly stroke patients, post-acute care must take a holistic approach, considering not only the stroke-related deficits but also pre-existing age-related health conditions. Older adults often have comorbidities, polypharmacy, and reduced physiological reserves, which can impact recovery and require integrated management. Addressing both aspects optimizes outcomes and prevents complications in this vulnerable population.

What is the maximum dose of IV alteplase for acute ischemic stroke treatment?

Answer: 0.9 mg/kg, max 90 mg

The standard dose of IV alteplase is 0.9 mg/kg with a maximum total dose of 90 mg.

When a SCRN professional identifies a potential regulatory violation, the CORRECT first step is to:

Answer: Document the violation and report it through proper channels

Proper documentation and reporting through established channels is the correct first step when identifying a potential violation. This ensures accountability, creates a paper trail, and allows appropriate parties to investigate and resolve the issue.

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 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.

What is a stroke?

Answer: A disruption of blood supply to the brain

A stroke, also known as a cerebrovascular accident (CVA), occurs when the blood flow to a part of the brain is interrupted or severely reduced. This deprives brain tissue of oxygen and nutrients, causing brain cells to die within minutes. This disruption can be due to a blocked artery (ischemic stroke) or a ruptured blood vessel (hemorrhagic stroke).

When conducting a risk assessment for SCRN operations, which factor should receive the HIGHEST priority?

Answer: Probability and severity of potential harm

The probability and severity of potential harm are the primary factors in risk assessment. While cost and convenience are considerations, they should never override the assessment of how likely an incident is and how severe its consequences could be.

A 58-year-old patient develops sudden onset diplopia, dysphagia, and ipsilateral facial numbness with contralateral body numbness. Which syndrome does this represent?

Answer: Wallenberg (lateral medullary) syndrome

Wallenberg syndrome results from posterior inferior cerebellar artery occlusion causing ipsilateral facial and contralateral body pain/temperature loss, dysphagia, dysarthria, and Horner syndrome.

A nurse is preparing a patient for mechanical thrombectomy. The patient's NIHSS score is 18 and CT angiography confirms large vessel occlusion. What time window is generally accepted for thrombectomy in eligible patients?

Answer: Up to 6 hours, and up to 24 hours in selected patients with favorable imaging

Current guidelines support thrombectomy up to 6 hours for standard eligibility and up to 24 hours for selected patients with perfusion imaging mismatch.

What role does monitoring intracranial pressure play in acute stroke care?

Answer: To manage brain swelling and prevent further injury

Intracranial pressure (ICP) monitoring is vital in acute stroke care, especially in severe cases or hemorrhagic strokes, because brain swelling (edema) is a common and dangerous complication. Elevated ICP can compress brain tissue, reduce cerebral blood flow, and lead to further neurological damage or herniation. Monitoring allows for timely interventions to reduce pressure and protect the brain.

What is the MOST important factor to consider when selecting assessment tools for SCRN certification work?

Answer: Validity, reliability, and appropriateness for the specific context

Assessment tools must be valid (measuring what they claim to measure), reliable (producing consistent results), and appropriate for the specific context and population. These psychometric properties ensure the quality of assessment outcomes.

What medication is commonly used for acute stroke patients to prevent complications?

Answer: Antiplatelet drugs

Antiplatelet drugs, such as aspirin, are commonly used for acute ischemic stroke patients (after ruling out hemorrhage) to prevent further clot formation and reduce the risk of early recurrent stroke. They work by inhibiting platelet aggregation, making the blood less likely to clot. This helps to maintain blood flow and prevent worsening of the ischemic event.

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.

During IV tPA administration, a patient suddenly develops angioedema with tongue and lip swelling. What is the immediate nursing action?

Answer: Stop the tPA infusion immediately and prepare to manage the airway

Orolingual angioedema is a life-threatening complication of alteplase; the infusion must be stopped immediately and airway management initiated.

A patient presents with bilateral leg weakness and urinary incontinence after a stroke. Which artery territory is most likely affected?

Answer: Anterior cerebral artery

The anterior cerebral artery (ACA) supplies the medial hemisphere including the leg area of the motor cortex; bilateral ACA involvement causes bilateral leg weakness and incontinence.

What is the BEST way for a Stroke Certified Registered Nurse professional to stay current with regulatory changes?

Answer: Actively monitor regulatory bodies, attend continuing education, and participate in professional associations

Staying current requires a multi-faceted approach: monitoring regulatory agencies directly, attending relevant continuing education programs, and participating in professional associations that disseminate regulatory updates.

Which documentation practice BEST demonstrates regulatory compliance for SCRN certified professionals?

Answer: Maintaining organized, dated, and signed records of all activities, training, and incidents

Organized, dated, and signed records demonstrate systematic compliance with regulatory requirements. Proper documentation serves as evidence during audits, protects against liability, and shows a pattern of consistent adherence to standards.

Which clinical finding in an acute stroke patient suggests hemorrhagic transformation of an ischemic infarct?

Answer: Sudden neurological deterioration, new severe headache, and rising blood pressure

Hemorrhagic transformation typically presents with abrupt neurological worsening, severe headache, and hypertension as blood extravasates into the infarct zone.

What role does calibration play in maintaining technical accuracy for Stroke Certified Registered Nurse professionals?

Answer: It ensures instruments and methods produce accurate, consistent results over time

Regular calibration ensures that instruments, tools, and methods continue to produce accurate and consistent results over time. Without calibration, measurement drift and equipment wear can lead to unreliable outcomes.