Which three symptoms are characteristic of Cushing triad associated with increased ICP?
Bradycardia, hypertension, and widening pulse pressure
Widening pulse pressure, headache, and seizure
Hypertension, tachycardia, and headache
Hypotension, tachycardia, and narrowing pulse pressure
The Correct Answer is A
A. Bradycardia, hypertension, and widening pulse pressure
This combination of symptoms is characteristic of Cushing's triad. Bradycardia (slow heart rate), hypertension (elevated blood pressure), and widening pulse pressure (difference between systolic and diastolic blood pressure) are indicative of increased ICP, specifically resulting in the compression of brain structures that regulate vital functions.
B. Widening pulse pressure, headache, and seizure
While headache and seizure may occur in patients with increased ICP, widening pulse pressure alone is not sufficient to meet the criteria of Cushing's triad. The presence of bradycardia and hypertension, along with widening pulse pressure, is more indicative of Cushing's triad.
C. Hypertension, tachycardia, and headache
Hypertension and headache may occur in patients with increased ICP, but the absence of bradycardia and widening pulse pressure makes this option less characteristic of Cushing's triad.
D. Hypotension, tachycardia, and narrowing pulse pressure
Hypotension (low blood pressure) and narrowing pulse pressure are not typically associated with Cushing's triad. Tachycardia (rapid heart rate) may occur in response to increased ICP, but it is usually accompanied by bradycardia rather than hypotension.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["15"]
Explanation
To calculate the dose of amantadine for a client with parkinsonism, the nurse needs to use the following formula:
Dose (mL) = Ordered dose (mg) / Concentration (mg/mL).
In this case, the ordered dose is 150 mg and the concentration is 50 mg/5 mL. Therefore, the dose in mL is:
Dose (mL) = 150 mg / (50 mg/5 mL)
Dose (mL) = 150 mg x (5 mL/50 mg)
Dose (mL) = 15 mL
The nurse should round the answer to the nearest whole number, which is 15 mL. The nurse should administer 15 mL of amantadine oral solution to the client.
Correct Answer is ["A","B","C","E"]
Explanation
A. Placing padding around or under the patient's head
This is a helpful instruction to include. Placing padding around or under the patient's head can help prevent injury during a seizure by cushioning the head against impact with the ground.
B. Positioning the patient on the side once the relaxation stage is entered to allow oral secretions to drain
This is a correct instruction. Positioning the patient on their side (recovery position) can help prevent aspiration if vomiting occurs during or after the seizure. It also helps clear oral secretions and maintain a clear airway.
C. Having the necessary equipment and/or personnel in case the patient doesn't spontaneously breathe when the seizure is over
This is an important instruction. It is crucial to have emergency equipment (such as oxygen and suction) readily available and to be prepared to provide respiratory support if the patient does not spontaneously breathe after the seizure.
D. Inserting a tongue depressor in the patient's mouth
This is an incorrect instruction. It is not recommended to insert anything into the patient's mouth during a seizure as it can cause injury to the teeth, gums, or airway. Additionally, it is a common misconception that tongue swallowing occurs during seizures, which is rare.
E. Noting the time the seizure started
This is a critical instruction. Noting the time the seizure started helps healthcare providers assess the duration of the seizure and determine if medical intervention is necessary. It also helps monitor the patient's recovery and response to treatment.
F. Holding the patient down to prevent injury
This is an incorrect instruction. Holding the patient down during a seizure can cause injury to both the patient and the person restraining them. It is important to create a safe environment by removing hazards and guiding the patient away from dangerous objects or situations, but holding them down is not appropriate.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today