Exam & Evaluation (Subarachnoid Hemorrhage: Caring for the Patient)
Questions: Please respond to following statements.
The 6 month mortality rate for persons with SAH secondary to ruptured cerebral artery aneurysm is about:
The most common type of aneurysm is a:
SAH is more prevalent in:
Which of the following structures is responsible for the absorption of cerebrospinal fluid?
The brain's anterior and posterior circulations join at the:
Circle of Willis
Middle cerebral artery
Which of the following aneurysms is classified as a giant aneurysm?
over 50 mm
All of the following may be symptoms of a minor aneurysmal bleed except:
During which of the following activities would a SAH most likely occur?
Lifting and moving furniture
Working at a computer
Which of the following are signs of increasing intracranial pressure?
Tachycardia, hypertension, lessening pulse pressure
Hypertension, bradycardia, widening pulse pressure
Bradycardia, hypotension, widening pulse pressure
Hypotension, tachycardia, lessening pulse pressure
An SAH patient with decerebrate posturing would be assigned to which classification on the Hunt and Hess scale?
The drug nimodipine is given for 21 days after SAH to prevent:
Performing a Valsalva maneuver after an SAH is contraindicated because the maneuver:
Lowers cerebral perfusion pressure
Increases intracranial pressure
Lowers systemic blood pressure
All of the following activities causes a Valsalva maneuver except:
Straining at stool
Keeping the head in extension
Turning in bed with the mouth closed
Cerebral vasospasms is treated with:
Calcium channel blocker
All of above
A patient with an SAH who is a poor surgical candidate may benefit from:
Serial lumbar punctures to lower intracranial pressure
Guglielmi Detachable Coil
Which of the following increases the potential for constipation and aneurysmal rebleeding?
Codeine given for SAH headache
1 and 2
A bowel program, including adequate hydration and stool softeners, should be implemented in the patient with SAH:
Within 24 to 48 hours of admission
The first post-operative day after aneurysmal surgery
All of the following are important nursing measures for a patient on aneurysm precautions except:
Head of bed at 30 degrees
Side rails up and bed in lowest position
Wrist and ankle restraints applied
Padded side rails, tongue blade, and suction
Which of the following should alert the nurse to a change in neurological status?
Increasing strength of hand grip on one side, apathy, decrease in pupillary reaction to light
Decrease in pupillary reaction to light, development of slurred speech, one sided facial weakness
Increase in alertness, slurred speech, unchanged pupillary reaction to light and accommodation
A lumbar puncture (LP) is dangerous in a person with increased intracranial pressure due to the possibility of brain herniation.
SAH rarely occurs without the patient complaining of a headache.
Aneurysm precautions are intended to prevent rapid increases in blood pressure that can precipitate rebleeding.
Signs and symptoms of aneurysmal rebleeding are subtle and gradual.
Hemodilution is part of hyperdynamic therapy.
Patients with aneurysm precautions are at high risk of deep vein thrombosis and potential pulmonary embolus.
Smoking is a risk factor for SAH.
Surgical clipping of cerebral aneurysms is usually done approximately one week after the initial hemorrhage.
The larger the hemorrhage, the more likely is vasospasm.
The word aneurysm comes from the Greek word "to widen."
It is rare for a cerebral aneurysm to occur in the very young or the very old.
Xanthochromia is a sign of SAH found in what body fluid? (three words)
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