A nurse is caring for a client who reports continuing problems related to migraines. The nurse is assessing the psychosocial impact of migraines on the client. Which of the following questions should the nurse include in the assessment?
(Select All that Apply.)

Choice A Reason:

Vasogenic cerebral edema is appropriate response. Vasogenic cerebral edema occurs due to disruption of the blood-brain barrier (BBB), leading to leakage of fluid and proteins from the blood vessels into the brain parenchyma. This type of cerebral edema is commonly associated with conditions such as brain tumors, abscesses, and ischemic stroke.

Choice B Reason:

Osmotic cerebral edema is inappropriate response. Osmotic cerebral edema occurs when there is an imbalance of osmotic forces across the blood-brain barrier, leading to the movement of water into the brain cells. This type of cerebral edema can result from conditions such as hyponatremia or the administration of hypertonic solutions.

Choice C Reason:

Cellular cerebral edema is inappropriate response. Cellular cerebral edema involves the swelling of brain cells (neurons and glial cells) due to various insults, such as ischemia, hypoxia, or metabolic disturbances. This type of cerebral edema can occur in conditions such as ischemic stroke or traumatic brain injury.

Choice D Reason:

Interstitial cerebral edema is incorrect response. Interstitial cerebral edema involves the accumulation of fluid within the interstitial spaces of the brain tissue. This type of cerebral edema can occur in conditions such as hydrocephalus, where there is obstruction of cerebrospinal fluid (CSF) flow.

Choice A Reason:

Prothrombin time (PT) is a laboratory test that measures the time it takes for blood to clot is incorrect. While PT may be part of a comprehensive evaluation in some cases, it is not typically the initial diagnostic test performed for a TIA. A TIA is caused by a temporary disruption of blood flow to the brain, often due to an embolus or transient blockage in a cerebral artery, rather than a primary disorder of blood clotting.

Choice B Reason:

Complete blood count (CBC) is incorrect. A complete blood count (CBC) is a common laboratory test that evaluates the cellular components of the blood, including red blood cells, white blood cells, and platelets. While CBC can provide valuable information about hematological conditions such as anemia or thrombocytosis, it is not specific to diagnosing the cause of a TIA. TIA is primarily a vascular event related to transient ischemia in the brain rather than a disorder of blood cell counts.

Choice C Reason:

Computerized tomography angiography (CTA) is appropriate. CTA is a non-invasive imaging test that combines computed tomography (CT) scanning with contrast dye to visualize blood vessels throughout the body, including those in the brain. CTA can help identify any blockages, narrowing, or abnormalities in the blood vessels supplying the brain, which may be contributing to the TIA. It provides detailed images of the blood vessels' structure and can help guide further management and treatment decisions.

Choice D Reason:

Transesophageal echocardiogram (TEE) is inappropriate. Transesophageal echocardiogram (TEE) is an imaging test that provides detailed images of the heart and major blood vessels using sound waves. While TEE may be indicated in some cases of TIA to evaluate for potential cardiac sources of emboli (blood clots), such as atrial fibrillation or cardiac valve abnormalities, it is not typically the first-line diagnostic test performed in the emergency department setting for evaluating a TIA. Initial imaging studies such as CTA or magnetic resonance imaging (MRI) of the brain are usually prioritized to assess for acute changes in cerebral blood flow and potential causes of the TIA.