Neurologic Case Study

Patient Profile:

Age: 68 years.

Gender: Male.

Medical History: Hypertension, Type 2 Diabetes Mellitus.

Medications: Lisinopril, Metformin.

Allergies: None.

Chief Complaint: The patient presents to the emergency department (ED) with a sudden onset of right-sided weakness and difficulty speaking that began approximately 1 hour prior to arrival.

Exhibits

What is a potential complication of the patient's condition?

Kidney failure

Aspiration pneumonia

Hypotension

Heart failure

Answer and Explanation

The Correct Answer is B

Choice A reason: Kidney failure is not a common immediate complication related to the patient's presentation of sudden right-sided weakness and difficulty speaking, which are indicative of a stroke. Although diabetes and hypertension can eventually lead to kidney issues, this is not an acute complication.

Choice B reason: Aspiration pneumonia is a potential complication of the patient's condition, especially given the presence of expressive aphasia. Patients with neurological deficits, particularly those affecting speech and swallowing, are at higher risk of aspirating food or liquids into the lungs, leading to pneumonia.

Choice C reason: Hypotension is not commonly a direct complication of a stroke, especially considering the patient's elevated blood pressure. Stroke patients often present with hypertension rather than hypotension.

Choice D reason: Heart failure, while related to the patient's underlying conditions like hypertension and possibly diabetes, is not an immediate complication of the acute neurological event described. The focus should be more on the neurological and respiratory complications.

Nursing Test Bank

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Free Nursing Study Resources

Correct Answer is D

Explanation

Choice A reason: Administering antibiotics is essential for treating cellulitis to eliminate the infection. However, it is not the immediate priority over maintaining oxygenation, especially in a patient with sickle cell disease.

Choice B reason: Starting IV fluids is crucial for preventing dehydration and helping to reduce the sickling of red blood cells. Nevertheless, while important, it is not the most urgent action compared to maintaining adequate oxygen levels.

Choice C reason: Assessing pain every 4 hours is necessary for managing the patient's comfort and monitoring the progression of the disease. Although pain management is a significant aspect of care, it is not the top priority in this scenario.

Choice D reason: Maintaining oxygenation is the highest priority for a patient with sickle cell disease. These patients are at increased risk for hypoxia, which can exacerbate the sickling of red blood cells, leading to severe complications such as acute chest syndrome or stroke. Ensuring adequate oxygenation helps to prevent these complications and stabilizes the patient's condition.

A. Anticipate obtaining a throat swab for rapid streptococcus testing B. Offer reassurance that the symptoms are common with budesonide use C. Suggest that the patient stop using the spray until the symptoms are resolved D. Teach the patient to gargle with water after using the budesonide

Correct Answer is D

Explanation

Choice A reason: Anticipating obtaining a throat swab for rapid streptococcus testing is not immediately related to the use of a budesonide inhaler. This test is typically done when there is a suspicion of a streptococcal infection, not specifically for managing asthma medication side effects.

Choice B reason: Offering reassurance that the symptoms are common with budesonide use may not fully address the patient’s concern or prevent potential complications. It is more effective to provide actionable advice that can help manage the symptoms.

Choice C reason: Suggesting that the patient stop using the spray until the symptoms are resolved could potentially worsen asthma control. Budesonide is an important medication for managing asthma, and discontinuing it without alternative treatment may lead to exacerbation of symptoms.

Choice D reason: Teaching the patient to gargle with water after using the budesonide inhaler is the most appropriate action. This practice helps to reduce the risk of developing oral thrush, a common side effect of inhaled corticosteroids like budesonide. Gargling with water removes any residual medication in the mouth, thereby minimizing the risk of infection.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient with sickle cell disease has developed cellulitis above the left ankle. Which action is the nurse's priority for this patient?

Correct Answer is D

Explanation

When a patient with asthma who is on a budesonide hand-held inhaler reports difficulty, what should the nurse do?

Correct Answer is D

Explanation

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