The nurse is planning discharge education for a client with trigeminal neuralgia. The nurse knows to include information about factors that precipitate an attack. What would the nurse be correct in teaching the client to avoid?

Drinking large amounts of fluids

Exposing skin to sunlight

Using artificial tears

Washing his face

Answer and Explanation

The Correct Answer is D

A. Drinking large amounts of fluids: Increased fluid intake is not known to trigger trigeminal neuralgia episodes. While extremely hot or cold beverages may cause discomfort, simply increasing fluid intake does not generally affect nerve stimulation or provoke pain.

B. Exposing skin to sunlight: Sunlight exposure does not typically trigger trigeminal neuralgia attacks. The condition is more closely related to mechanical or thermal stimulation of the face, rather than UV exposure or heat from the sun.

C. Using artificial tears: Using artificial tears involves minimal contact with the face and is often done gently. It is unlikely to stimulate the trigeminal nerve branches in a way that would provoke an attack, especially if applied carefully.

D. Washing his face: Washing the face is a common trigger for trigeminal neuralgia due to stimulation of the affected facial nerve branches. Even light tactile stimulation can provoke sudden, severe, shock-like facial pain, making this a critical activity to modify or avoid.

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Correct Answer is A

Explanation

A. Place the client in a high-Fowler's position: Elevating the head of the bed helps lower blood pressure by promoting venous pooling in the lower extremities, reducing cerebral blood flow and pressure. This is the immediate priority intervention to help prevent stroke and other complications associated with autonomic dysreflexia.

B. Obtain the client’s heart rate: Monitoring vital signs is important but is not the first action. Identifying and managing the cause of hypertension takes precedence over assessing heart rate once autonomic dysreflexia is suspected.

C. Assess the client for bladder distention: Bladder distention is a common trigger for autonomic dysreflexia and must be relieved quickly. However, after positioning the client upright to reduce blood pressure, the nurse should then promptly assess and treat potential triggers such as bladder distention.

D. Administer a nitrate antihypertensive: Medications may be needed if blood pressure remains elevated after removing the trigger and positioning, but pharmacologic intervention is not the initial step. Priority is to reduce blood pressure safely with nonpharmacologic measures first.

A. Drowsiness is normal for the first week after discharge B. Mild, intermittent seizures can be expected C. Take ibuprofen for complaints of a serious headache D. Take antihypertensive medication as prescribed

Correct Answer is D

Explanation

A. Drowsiness is normal for the first week after discharge: Persistent drowsiness after a hemorrhagic stroke may indicate complications such as increased intracranial pressure or recurrent bleeding. It should be reported promptly rather than considered normal.

B. Mild, intermittent seizures can be expected: While seizures can occur after a stroke, especially hemorrhagic, they are not expected or normal. Any seizure activity requires medical evaluation and management.

C. Take ibuprofen for complaints of a serious headache: Ibuprofen is generally avoided after hemorrhagic stroke because it can increase bleeding risk due to its antiplatelet effects. Clients should be advised to report severe headaches to their healthcare provider instead.

D. Take antihypertensive medication as prescribed: Controlling blood pressure is critical after a hemorrhagic stroke to prevent rebleeding and further neurological damage. Adherence to prescribed antihypertensive therapy is essential for optimal recovery and prevention of complications.

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The nurse is planning discharge education for a client with trigeminal neuralgia. The nurse knows to include information about factors that precipitate an attack. What would the nurse be correct in teaching the client to avoid?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Explanation

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