A client with an ischemic stroke has right-sided weakness and slurred speech.
Which complication should the nurse prioritize monitoring for in the first 24 hours?

Discharge teaching for post-radiation brain tumor patients requires understanding oncology and pharmacology. Knowledge of medication adherence, symptom monitoring for increased intracranial pressure, and integumentary protection is needed. Identifying misconceptions ensures patient safety and prevents potential neurological relapse or secondary injury.

Choice A rationale

Abrupt cessation of medications, especially anticonvulsants or steroids used in neuro-oncology, can trigger rebound edema or seizures. Maintaining therapeutic blood levels is critical for managing potential complications after radiation therapy has concluded to ensure neurological stability.

Choice B rationale

Headaches and visual disturbances are primary indicators of increased intracranial pressure or tumor recurrence. Patients must recognize these signs as urgent neurological changes that require immediate medical evaluation to prevent brain herniation or permanent functional loss.

Choice C rationale

Radiation therapy damages the DNA of skin cells, leading to thinning and increased sensitivity. Protecting the scalp from ultraviolet radiation prevents severe dermatitis and secondary burns on tissue that already has compromised healing capabilities.

Choice D rationale

Gradual reintegration into daily life is standard post-treatment advice. While energy levels dictate activity, resuming normal routines as tolerated is appropriate, provided the patient avoids hazardous activities if they have residual neurological deficits or seizure risks.

Management of esophageal varices requires reducing the pressure gradient within the portal venous system. This scenario necessitates applying knowledge of splanchnic vasoconstriction and hemodynamic stability to prevent life-threatening hemorrhage and manage portal hypertension through pharmacological intervention and nursing surveillance.

Choice A rationale

Lactulose is a synthetic disaccharide that lowers blood ammonia levels by acidifying colonic contents and promoting excretion. While used in hepatic encephalopathy, it does not directly reduce portal hypertension or stop acute variceal bleeding.

Choice B rationale

Propranolol is a nonselective beta-blocker that reduces portal pressure by decreasing cardiac output and causing splanchnic vasoconstriction. It is the gold standard for preventing further variceal bleeding by lowering the hepatic venous pressure gradient.

Choice C rationale

Omeprazole is a proton pump inhibitor that reduces gastric acid secretion by inhibiting the hydrogen-potassium ATPase pump. While it prevents stress ulcers and treats gastritis, it has no direct hemodynamic effect on portal venous pressure.

Choice D rationale

Furosemide is a loop diuretic that inhibits sodium and chloride reabsorption in the loop of Henle. It is used to manage ascites or edema but does not effectively target the portal hypertension causing varices.