3. Signs/Symptoms Which of the following is not a symptom of CVA? [k] 1. Headache 2. Lethargy 3. Lumbarpain 4. Blurredvision
4. Your co-worker states, “I always heard that PAF is a precursor to stroke.” Is this statement true or false? [k] True. There is overwhelming evidence to link PAF to increased stroke risk. Studies have shown that patients with PAF should be on chronic anticoagulation.
5. What other information would be necessary for evaluating the cause for the CVA? N.T. had a history of PAF; an ECG would be necessary to evaluate rhythm status. An echo- cardiogram would be helpful for evaluating the possibility of thrombi in the atria or ventricle. A carotid US is used to identify any atherosclerotic plaques.
6. Why was the initial CT scan negative for stroke? Cell death does not occur immediately following a CVA. It may take up to 12 hours for cell death to be detected by CT. MRI may be a better option, along with a complete history and physical.
7. What lab test may be abnormal during CVA? The isoenzyme CK-BB is measured to detect brain tissue injury.
14. Suggested NOC outcomes:Ambulation, Ambulation: Wheelchair, Mobility, Self-Care: Activities of Daily Living (ADLs), Instrumental Activities of Daily Living (IADLs), Transfer Performance
18. Suggested NIC interventions: Cognition as evidenced by the following indicators: Cognitive orientation/Communicates clearly/Comprehends the meaning of situations/Attentiveness/Concentration (Rate the outcome and indicators of Cognition: 1 severely compromised, 2 substantially compromised, 3 moderately compromised, 4 mildly compromised, 5 not compromised see Section I.)
