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

Answer and Explanation

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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Correct Answer is D

Explanation

A. "I stopped taking aspirin last week.": Stopping aspirin medication prior to surgery is often advised to reduce the risk of bleeding during and after the procedure. The nurse may confirm the timing of discontinuation with the client and verify if any other anticoagulant medications are being taken.

B. "I did not put my contact lenses in this morning.": Removing contact lenses before surgery is a routine precaution to prevent potential corneal abrasions or complications during the procedure. This statement indicates the client is following preoperative instructions.

C. "I took my blood pressure meds with a sip of water.": Taking blood pressure medications with a small amount of water is generally acceptable before surgery. However, the nurse may verify the specific medications the client is taking and their dosing schedule to ensure compliance.

D. "I had a cough and runny nose a couple days ago.": This statement requires further investigation as respiratory symptoms, such as cough and runny nose, may indicate an underlying respiratory infection. Infections can increase the risk of complications during surgery, such as anesthesia-related respiratory issues or postoperative infections. The nurse should assess the severity and duration of the symptoms, inquire about any fever or recent exposure to illnesses, and consider notifying the surgical team for further evaluation and decision-making regarding the client's surgical readiness.

A. "Have you had any trauma to the eye?" B. "Do you regularly lift heavy objects?" C. "How much sodium is in your diet?" D. "Do you wear sunglasses when in direct sunlight?" E. "Do you take steroids?"

Correct Answer is ["A","D","E"]

Explanation

A. "Have you had any trauma to the eye?": Trauma to the eye can be a significant risk factor for retinal detachment. Inquiring about any history of eye trauma is essential to understand potential causes or contributing factors.

D. "Do you wear sunglasses when in direct sunlight?": Prolonged exposure to sunlight without eye protection can increase the risk of retinal detachment. Wearing sunglasses with UV protection can help prevent eye damage, including retinal detachment.

E. "Do you take steroids?": Steroid use, especially long-term or systemic steroids, can increase the risk of developing retinal detachment. Steroids may lead to changes in the structure and integrity of ocular tissues, predisposing individuals to retinal detachment.

Options B and C are not directly related to the risk factors for retinal detachment:

B. "Do you regularly lift heavy objects?" - Regularly lifting heavy objects can increase pressure in the eyes, which can contribute to retinal detachment.:

C. "How much sodium is in your diet?": Sodium intake is not directly linked to the risk of retinal detachment. While diet and nutrition play a role in overall eye health, sodium consumption is not a specific risk factor for retinal detachment.

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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?

Nursing Test Bank

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Explanation

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