Patient Data

Exhibits

The client continues to have stable neurologic assessments. The nurse provides interventions to promote client safety while in the hospital. Click to indicate which interventions promote client safety. Each column must have at least one response selected.

Rationale:

• Ambulates with a walker: Being able to walk, even with assistance, indicates improved muscle control and coordination on the affected side. This shows progress in motor recovery and suggests that blood flow has been restored to motor areas of the brain.
• Tearful sharing of stories: Expressing emotion and recalling events indicate intact cognitive and communicative function. While post-stroke emotional lability can occur, this behavior also shows higher cortical functioning, which supports improved cerebral perfusion after treatment.
• Speaks in short sentences: The ability to form and express language suggests that expressive and receptive language centers in the brain are functioning. Improvement in speech following initial garbling indicates that early ischemic stroke interventions are showing clinical benefits.

Rationale for Incorrect Choices:

• Flaccidity of left arm: Persistent flaccidity implies ongoing neurological deficit and poor motor control on the affected side. This finding suggests that motor recovery has not yet occurred and may indicate continued brain tissue injury.
• Passive range of motion of the left leg: Requiring passive movement assistance reflects impaired voluntary motor control. This does not support improved function or stroke recovery, as it indicates dependence rather than restored movement.
• Fits of laughter: Sudden, inappropriate emotional expressions can signify pseudobulbar affect, a post-stroke complication. While common, it reflects disrupted emotional regulation rather than clinical improvement.
• Angry outbursts: Emotional instability, including irritability and anger, may result from frontal lobe injury. It reflects emotional dysregulation, which can be a lingering or worsening effect of neurological damage, not an indicator of recovery.
• Drinks with repetitive cough: Coughing when drinking signals impaired swallowing reflex and a risk for aspiration. This suggests that brain areas controlling swallowing are still affected, showing unresolved neurological deficits.
• Decorticate posturing: This is a sign of severe brain injury and poor prognosis. It indicates worsening intracranial damage, not a positive response to ischemic stroke treatment.

Rationale:
A. Full volume of pedal pulses: Pedal pulses reflect peripheral arterial circulation, not neuropathic pain. Pregabalin does not affect vascular flow, so this finding is unrelated to the medication’s intended effect.

B. Reduced level of pain: Pregabalin is an anticonvulsant used to treat neuropathic pain by modulating nerve signals. A reduction in reported pain confirms that the medication is helping manage the client’s diabetic nerve pain.

C. Granulating tissue in foot ulcer: Wound healing is influenced by infection control, circulation, and blood glucose management—not directly by pregabalin. While important, this finding does not measure the drug’s effectiveness for neuropathy.

D. Improved visual acuity: Visual changes are not treated with pregabalin and may be associated with diabetic retinopathy. Pregabalin does not improve vision and is not indicated for ocular complications of diabetes.