The nurse is assisting with planning care for a client who has a subarachnoid hemorrhage (SAH). Which of the following relates to a high mortality rate for a client who has an SAH?
Poor functional ability
Rebleeding of the injury
Decreased cerebrospinal fluid
Use of nimodipine
The Correct Answer is B
A. Poor functional ability: While poor functional ability may impact the overall prognosis and quality of life for a client with a subarachnoid hemorrhage (SAH), it is not directly associated with a high mortality rate. Functional ability can be improved with rehabilitation and supportive care.
B. Rebleeding of the injury: Rebleeding of the SAH is a significant risk factor associated with a high mortality rate. Rebleeding can lead to increased intracranial pressure, worsening neurological deficits, and even death. Preventing rebleeding is a critical aspect of managing SAH to improve outcomes.
C. Decreased cerebrospinal fluid: Decreased cerebrospinal fluid (CSF) may indicate conditions such as hydrocephalus, which can complicate the management of SAH. However, it is not directly associated with a high mortality rate compared to rebleeding.
D. Use of nimodipine: Nimodipine is a calcium channel blocker commonly used in the management of SAH to prevent cerebral vasospasm, which can lead to ischemia and worsen outcomes. While nimodipine plays a role in improving outcomes by preventing vasospasm, its use is not directly associated with mortality rates.
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Related Questions
Correct Answer is B
Explanation
A. Decrease sedation: Decreasing sedation may help reduce intracranial pressure (ICP) by allowing the client to have a more responsive level of consciousness. However, it is not a direct treatment for brain herniation. Sedation reduction should be done cautiously to prevent agitation and further increases in ICP.
B. Hyperventilate the client: Hyperventilation is a temporary intervention used to reduce intracranial pressure by inducing cerebral vasoconstriction, which decreases cerebral blood flow and intracranial volume. However, it is typically reserved for acute situations and is not considered a definitive treatment for brain herniation. Prolonged or excessive hyperventilation can lead to cerebral ischemia and should be used cautiously.
C. Lower blood pressure: Lowering blood pressure may help reduce cerebral perfusion pressure, which can mitigate the risk of further brain injury during herniation. However, lowering blood pressure alone is not a direct treatment for brain herniation. It may be part of the overall management strategy to prevent secondary injury.
D. Reduce the temperature in the room: Reducing the temperature in the room, or therapeutic hypothermia, is sometimes used in the management of elevated intracranial pressure and brain injury. Lowering body temperature can reduce metabolic demands and cerebral edema, thereby lowering intracranial pressure. However, it is not a direct treatment for brain herniation and should be implemented cautiously to prevent complications such as shivering and hypotension.
Correct Answer is ["A","B","C","D","E"]
Explanation
A. Restlessness: Restlessness is a common behavioral manifestation in clients with Alzheimer's disease. It can be caused by various factors, including confusion, agitation, discomfort, or unmet needs. Restlessness may manifest as pacing, fidgeting, or difficulty sitting still.
B. Aggression: Aggression, including verbal or physical aggression, is a behavioral manifestation that can occur in clients with Alzheimer's disease. Aggression may result from frustration, confusion, fear, or other underlying factors. It can present challenges for both the individual with Alzheimer's and their caregivers.
C. Depression: Depression is a mood disorder that can occur in individuals with Alzheimer's disease. Symptoms of depression may include persistent sadness, feelings of hopelessness, social withdrawal, and loss of interest in previously enjoyed activities. Depression can exacerbate cognitive decline and functional impairment in individuals with Alzheimer's.
D. Hyperactivity: Hyperactivity, characterized by excessive or restless activity, can occur in some individuals with Alzheimer's disease. Hyperactivity may be a manifestation of agitation, anxiety, or other underlying factors. It can present challenges for caregivers and may require interventions to manage.
E. Lethargy: Lethargy, or extreme fatigue and lack of energy, can also occur in individuals with Alzheimer's disease. Lethargy may result from physical and cognitive decline, medication side effects, depression, or other medical conditions. It can contribute to decreased engagement in activities and worsening of cognitive function.
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