Question

***Questions 12-15 refer to the following patient: A 28-year-old woman with a history of severe HTN and a current BP of 190/118 presents to the ER with certain S&S that are consistent with brain attack (stroke). A CAT scan shows bleeding in one hemisphere of the cerebrum. Review the list of statements ( AQ) below and highlight the ones that would be consistent with the scenario above, as well as what you've learned from your readine. Note that you are not told which hemisphere has the bleeding. Take each sentence below as a separate possibility of many-le, each statement separately needs to match what you know about strokes, as well as what is given in the scenario. Think of the relationship between patho, causes, S&S, interventions, etc. Possible CORRECT answers are arranged in questions 12.15-choose one from each. 4 DAY G. H. The bleeding in the brain is likely caused by decreased cerebral perfusion pressure secondary to hypertension. If the patient denies the presence of people standing on her left side, this would be consistent with a problem called left-sided neglect. The bleeding caused irritation of the brain, inflaming the area and causing edema to press pathologically on certain corticospinal tracts that control the contralateral side of the body below the shoulders. Right-sided neglect is the term given when, due to impaired spatiality controlled by the left hemisphere, a patient denies the presence of people standing on her right side. Sensorimotor changes above the shoulders usually reflect impairment that is on the same side of the face as the brain hemisphere that has bleeding and/or edema. if the patient is unable to talk, she is also probably unable to smile on the left side of her face. tion of the brain, inflaming the area and causing edema to press pathologically on certain corticospinal tracts that control the same side of the body below the shoulders. If the bleeding is in the left hemisphere, the patient is likely to have right-sided neglect related to impairment of spatiality. Interventions for this patient should include raising the head of the bed to about 30 degrees to minimize increased ICP. Sensorimotor changes above the shoulders reflect impairment that is on the same side of the brain as the brain hemisphere that has bleeding and/or edema. Interventions for this patient should include an anticoagulant to prevent pathological clotting in the areas of cerebral edema. If the bleeding is in the right hemisphere, the patient is likely to deny that she has any illness or impairment at all. If the patient is unable to talk, she has probably developed a Babinski reflex. If upon assessment, the patient has a weak hand grip on the left and normal strength of the right hand grip, the brain bleed is most likely in the right cerebral hemisphere. Testing shows that the patient has lost some math skills, demonstrating the likelihood that a special functions" portion of the right cerebral hemisphere has been compromised. Assessment findings on this patient likely include nystagmus, a typical problem in hemispheric strokes. MY 0. In each of questions 12, 13, 14, & 15, choose the answer that is correct from A-P 12. 15. K a. a. ь C D н G novo Suo N

Answer 1

12. G. The bleeding caused irritation of the brain, inflaming the area and causing oedema to press pathologically on certain corticospinal tracts that control the same side of the body below the shoulders.

13. I. Interventions for this patient should include raising the head of the bed to about 30 degrees to minimize the increased ICP.

14. P. Assessment findings on this patient likely include nystagmus, a typical problem in hemispheric strokes.

15. A. The bleeding in the brain is likely caused by decreased cerebral perfusion pressure secondary to hypertension.