The nurse is assessing a client experiencing motor loss as the result of a left-sided stroke. Which of the following clinical manifestations related to motor loss would the nurse document?
Impulsive behavior and hostility toward family
Hemiparesis of the client's left arm and apraxia
Homonymous hemianopia on the left side and diplopia
Paralysis of the right side of the body and ataxia
The Correct Answer is D
A. These are behavioral changes that may occur after a stroke, but they are not directly related to motor loss.
B. Hemiparesis is weakness on one side of the body, but in this case, the client is experiencing motor loss on the right side. Apraxia is the inability to perform purposeful movements, which can also occur after a stroke, but it is not a direct manifestation of motor loss.
C. Homonymous hemianopia is the loss of vision in half of the visual field on the same side as the stroke. Diplopia is double vision. While these are both common symptoms of stroke, they are not related to motor loss.
D. A left-sided stroke typically results in motor loss on the right side of the body. This is because the left side of the brain controls the right side of the body. Additionally, ataxia, which is a lack of coordination, is a common symptom of stroke.
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Related Questions
Correct Answer is C
Explanation
A. This intervention can be appropriate since a very low platelet count increases the risk of bleeding, including gastrointestinal bleeding. However, this action alone does not directly address the immediate risks associated with the low platelet count.
B. While hydration is important for overall health, this intervention does not specifically address the risks associated with a low platelet count. Additionally, excessive fluid intake may not be appropriate for all patients, especially if there are underlying kidney issues or fluid restrictions.
C. Clients with AML and low platelet counts are at increased risk for infections and may develop febrile neutropenia. Monitoring temperature every four hours can help detect early signs of infection, allowing for timely intervention.
D. While maintaining oral hygiene is important, especially in patients undergoing chemotherapy, this intervention may not be the most critical action based on the acute concern of a very low platelet count. However, it is important to note that patients with low platelet counts may also experience bleeding from the gums, making gentle oral care essential.
Correct Answer is ["A","C","D","E"]
Explanation
A. Multiple myeloma can lead to dehydration and kidney problems. Increasing fluid intake helps to prevent these complications and can also help to reduce the risk of infections.
B. This statement is incorrect. Aspirin should not be taken unless prescribed by a doctor. It can increase the risk of bleeding in people with multiple myeloma.
C. Multiple myeloma can weaken the immune system, making the client more susceptible to infections. Using fragrance-free gel soap can help to reduce the risk of skin irritation and infections.
D. Multiple myeloma can cause bone pain. Using analgesics as needed can help to manage this pain and improve the client's quality of life.
E. Multiple myeloma can weaken bones, increasing the risk of fractures. Installing grab bars in the shower can help to prevent falls and reduce the risk of injuries.
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