Progressive Care Questions and Answers | Exams Nursing

Progressive Care Questions and

Answers

Annually: Hemispheres Level 8 NIHSS plus one other Hemispheres education

module (varies by unit).

There are also opportunities to attend stroke offerings from the Bi State Consortium

or equivalent. -

✔What kind of stroke nursing education do you receive?

Call 8-5656 and ask for the stroke team -

✔How do you activate the stroke team?

Stroke Team RN from Neuro ICU and the Neurology resident, plus a Vascular

Neurologist is on call -

✔Who responds to a stroke call?

0-4.5 hours from symptom onset -

✔What is the time window that a patient may be eligible to receive tPA?

As ordered and/or per unit standard -

✔When do you use the NIH stroke scale?

Prior to anything PO on any patient with stroke like symptoms -

✔When do you perform the stroke dysphagia screening?

Keep the patient NPO, notify physician and ensure that they order a formal swallow

eval by Speech Therapy -

✔What do you do if the patient fails the stroke dysphagia screening?

Stop administering medications or food, make patient NPO, notify physician and

ensure that they order a formal swallow eval by Speech Therapy -

✔What do you do if a patient passes a dysphagia screen, but starts to cough

when taking medication or eating?

Each stroke patient gets a Stroke education folder and other educational handouts

are also available through EPIC -

✔What type of educational materials are available for stroke patients?

In the doc flowsheets, under Stroke Dysphagia Screen section -

✔Where is the stroke dysphagia screening documented?

They are integrated in our stroke order sets -

✔Where are our clinical practice guidelines for stroke?

In Epic under the education tab -

✔Where do you document stroke education provided to the patient?

Two good examples are team huddles if your unit has them and/or interdisciplinary

rounds on the unit -

✔How do you involve the interdisciplinary team in stroke care?

Activate the stroke team -

✔What would you do if your stroke patient seemed to be deteriorating

neurologically?

NIHSS at least once a shift, focused stroke and neuro assessments at least once

every 4 hours -

✔What sort of assessments do you do on your stroke patients to pick up neuro

changes?

Personal risk factors, warning signs of stroke, activation of EMS/calling 911, need for

follow up after discharge, medications prescribed -

✔What's reviewed when you are educating stroke patients for discharge?

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Progressive Care Questions and

Answers

Annually: Hemispheres Level 8 NIHSS plus one other Hemispheres education module (varies by unit). There are also opportunities to attend stroke offerings from the Bi State Consortium or equivalent. - ✔What kind of stroke nursing education do you receive? Call 8-5656 and ask for the stroke team - ✔How do you activate the stroke team? Stroke Team RN from Neuro ICU and the Neurology resident, plus a Vascular Neurologist is on call - ✔Who responds to a stroke call? 0-4.5 hours from symptom onset - ✔What is the time window that a patient may be eligible to receive tPA? As ordered and/or per unit standard - ✔When do you use the NIH stroke scale? Prior to anything PO on any patient with stroke like symptoms - ✔When do you perform the stroke dysphagia screening? Keep the patient NPO, notify physician and ensure that they order a formal swallow eval by Speech Therapy - ✔What do you do if the patient fails the stroke dysphagia screening? Stop administering medications or food, make patient NPO, notify physician and ensure that they order a formal swallow eval by Speech Therapy - ✔What do you do if a patient passes a dysphagia screen, but starts to cough when taking medication or eating? Each stroke patient gets a Stroke education folder and other educational handouts are also available through EPIC - ✔What type of educational materials are available for stroke patients? In the doc flowsheets, under Stroke Dysphagia Screen section - ✔Where is the stroke dysphagia screening documented? They are integrated in our stroke order sets - ✔Where are our clinical practice guidelines for stroke? In Epic under the education tab - ✔Where do you document stroke education provided to the patient? Two good examples are team huddles if your unit has them and/or interdisciplinary rounds on the unit - ✔How do you involve the interdisciplinary team in stroke care? Activate the stroke team - ✔What would you do if your stroke patient seemed to be deteriorating neurologically? NIHSS at least once a shift, focused stroke and neuro assessments at least once every 4 hours - ✔What sort of assessments do you do on your stroke patients to pick up neuro changes? Personal risk factors, warning signs of stroke, activation of EMS/calling 911, need for follow up after discharge, medications prescribed - ✔What's reviewed when you are educating stroke patients for discharge?

In Epic go to Manage Orders tab and sort by Order Set - ✔How can you see if the patient is on a stroke order set? You can refer to the Neuro section of the doc flowsheet or the Lippincott procedure "Assessment, Adult Progressive Care-TUKH" - ✔What's included in your neuro assessment? Location may vary by unit but you should know for your specific unit - ✔Where are the stroke patient folders kept? Examples include: Discuss the plan of care Ask the patient for a "goal for today" and post on white board Ask patient to identify their risk factors for stroke - ✔What are ways to involve the patient or family in their care? Examples include: fall prevention, HAPI prevention, CAUTI/CLABSI prevention - ✔Can you give some examples of quality improvement projects that your unit focuses on? Craniectomy - ✔What surgery may be performed to allow for brain edema without herniation? Every patient who is admitted with an ischemic or hemorrhagic stroke needs stroke care. It may tell you in the admitting diagnosis, H&P, or if the stroke order set is used. - ✔How do you know if a patient needs stroke care? Look in progress notes - ✔Where can you find information about interdisciplinary care the patient is receiving? Each person will have a different answer but hopefully can think of something! :-) - ✔What are you proud of on your unit? At least 24 hours - ✔How long will a patient stay in ICU after tPA is administered? Mechanical thrombectomy - ✔Name a neurointervention an acute stroke patient with a large vessel stroke may be eligible for.

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Progressive Care Questions and

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