Why did the patient's wife's husband not receive clot-busting medication (tPA)?

Correct Answer: D

Rationale: The correct answer is D) The medication you are talking about dissolves clots and could cause more bleeding in your husband's brain. This is the correct answer because tissue plasminogen activator (tPA) is a clot-busting medication used to treat strokes caused by blood clots. However, it is crucial to determine the type of stroke before administering tPA because if the stroke is caused by a hemorrhage (bleeding in the brain), giving tPA could worsen the condition by causing more bleeding. Option A is incorrect because it only mentions the timeframe for therapy and does not address the specific concern about the risk of bleeding in the brain. Option B is incorrect because it focuses on surgery as a factor for eligibility for tPA, which is not directly related to the specific situation of the patient's husband. Option C is incorrect because it does not provide a clear explanation of why tPA was not administered to the patient's husband and redirects the discussion to the doctor without addressing the potential risks of the medication. In an educational context, it is important for healthcare providers to understand the criteria and contraindications for administering clot-busting medications like tPA to ensure patient safety and optimal outcomes. Recognizing the type of stroke and assessing the risks and benefits of treatment options are critical skills in managing patients with neurological conditions.

Correct Answer: C

Rationale: In caring for patients with chronic, progressive neurologic diseases, the major goal of treatment that the nurse works toward is to maximize neurologic functioning for as long as possible (Option C). This goal is crucial as it focuses on optimizing the patient's quality of life by maintaining and enhancing their neurological capabilities, which can help delay the progression of the disease and minimize the impact of symptoms. Option A, meeting the patient's personal care needs, is important in overall patient care but does not specifically address the primary goal of managing a neurologic disease. Option B, returning the patient to normal neurologic function, is often not achievable in chronic progressive conditions but rather aims for functional maintenance and enhancement. Option D, preventing the development of additional chronic diseases, is a valid aspect of care but not the primary goal when managing an existing neurologic condition. From an educational standpoint, understanding the primary treatment goal in chronic neurologic diseases helps nurses prioritize care interventions, set realistic expectations for patients and families, and collaborate effectively with the healthcare team to provide comprehensive and patient-centered care. It emphasizes the importance of proactive management strategies to optimize neurologic function and enhance the patient's overall well-being in the context of a progressive disease process.

Correct Answer: A

Rationale: In the context of providing respite care for a caregiver of a patient with neurological issues, the appropriate nursing intervention is to help the wife arrange for adult day care for the patient (Option A). This option promotes temporary relief for the caregiver while ensuring the patient's care needs are met in a safe environment. Adult day care centers offer structured activities and supervision for patients, providing much-needed respite for caregivers. Encouraging permanent placement of the patient in an Alzheimer's unit (Option B) may not align with the caregiver's wishes or the patient's best interests in terms of maintaining family relationships and individualized care. Referring the wife to a home health agency for daily nursing visits (Option C) may not provide sufficient respite as the caregiver may still be responsible for a significant portion of care outside of nursing visits. Hospitalizing the patient for the caregiver's convenience (Option D) is not an ethical or appropriate solution for respite care as it can disrupt the patient's routine and may not be medically necessary. Educationally, understanding the importance of respite care in preventing caregiver burnout and maintaining quality care for patients is essential for nursing practice. Nurses play a crucial role in supporting caregivers and ensuring they have access to appropriate respite services to promote their well-being and the well-being of the patients under their care.

Correct Answer: C

Rationale: The correct answer is C) Fractured humerus. In this scenario, the description provided in the question aligns with a fracture of the humerus that leads to radial nerve and brachial artery damage. A hanging arm cast is often used to treat a fractured humerus, which helps in the reduction of the fracture. Option A) Fractured tibia is incorrect because the tibia is a bone in the lower leg, not the arm where the radial nerve and brachial artery are located. Option B) Colles' fracture is a specific type of fracture that occurs in the distal radius of the forearm, not the humerus. Option D) Femoral shaft fracture involves the thigh bone (femur), which is not consistent with the description provided in the question. Understanding the specific signs and symptoms associated with different types of fractures is crucial in the field of health assessment. Recognizing the relationship between the location of the fracture, associated nerve and vascular damage, and appropriate treatments such as the hanging arm cast is essential for healthcare professionals, particularly those involved in orthopedic care and rehabilitation. This knowledge helps in accurate diagnosis, treatment planning, and patient care, highlighting the importance of a comprehensive understanding of the musculoskeletal system and associated injuries.

Correct Answer: A

Rationale: Rationale: A) To prevent flexion contractures Positioning a patient with an above-the-knee amputation prone several times a day is crucial to prevent flexion contractures. Flexion contractures occur when the residual limb remains in a flexed position for an extended period, leading to muscle shortening and joint stiffness. By placing the patient prone, the hip joint is extended, helping to maintain the range of motion and prevent contractures. B) To assess the posterior skin flap Assessing the posterior skin flap is important after surgery to ensure proper healing and detect any signs of infection or complications. However, this does not require positioning the patient prone several times a day. Regular wound assessments can be done in a supine or side-lying position without the need for prone positioning. C) To reduce edema in the residual limb While elevating the residual limb can help reduce edema by promoting venous return, prone positioning may not be the most effective method for edema management. Elevating the limb above heart level is more commonly used to reduce edema in the immediate post-amputation period. D) To relieve pressure on the incision site Relieving pressure on the incision site is important for wound healing and preventing complications. However, prone positioning may not be the most optimal way to relieve pressure on the incision site of an above-the-knee amputation. Proper wound care, padding, and elevation are more effective strategies for relieving pressure. Educational context: Understanding the rationale behind positioning patients with above-the-knee amputations is crucial for nurses providing post-operative care. By preventing flexion contractures through appropriate positioning, nurses can help promote optimal outcomes for patients undergoing amputation surgery. It is essential for nurses to have a comprehensive understanding of positioning techniques to prevent complications and promote patient recovery.