A patient asks the nurse how to prevent a stroke. Which statement by the nurse is correct? Select all that apply.

A. Keep affected body areas covered at all times: While keeping warm can help prevent attacks, it is not practical or necessary to cover the areas all the time, especially in warmer environments.
B. Avoid stimulation that causes vasoconstriction: Raynaud disease is triggered by factors that cause vasoconstriction, such as exposure to cold or stress. Avoiding these triggers is key to preventing attacks.
C. Get plenty of outdoor exercise all year: Exercise is beneficial for general health but exposure to cold during outdoor activities can trigger Raynaud's attacks, especially in cold weather.
D. Take vasopressors to prevent exacerbation of symptoms: Vasopressors cause vasoconstriction and would likely worsen Raynaud's symptoms rather than preventing them.

Condition the Patient is Most Likely Experiencing:

Intracerebral Haemorrhage (ICH) : The patient presents with a severe headache, lethargy, decreased level of consciousness, and slurred, incomprehensible speech, which are common signs of a stroke or intracerebral haemorrhage. A history of hypertension and atrial fibrillation increases the risk for both ischemic and hemorrhagic strokes. The use of apixaban, an anticoagulant, suggests the patient is at risk for bleeding complications, including intracerebral haemorrhage.

Interventions to Perform/Anticipate:

1. Perform a CT Scan of the Head:
   • Rationale: A CT scan will help determine if there is bleeding or an ischemic event in the brain. It is crucial for differentiating between ischemic and hemorrhagic stroke, guiding subsequent treatment.
2. Administer Intravenous Antihypertensives:
   • Rationale: Controlling blood pressure is critical to reduce the risk of further bleeding in the brain. Immediate BP management is essential in the acute setting of suspected stroke.

Parameters to Monitor:

1. Neurological Status:
   • Rationale: Monitoring changes in the patient’s level of consciousness, pupil reactions, and motor response will help assess the progression of the neurological deficit and effectiveness of interventions.
2. Blood Pressure:
   • Rationale: Maintaining blood pressure within a safe range is essential to prevent exacerbation of the hemorrhage. Hypertension management is key to avoid further complications.