A patient who just suffered a hemorrhagic stroke is brought to the emergency department by ambulance. What would the nurse's primary assessment focus on?
A) Cardiac and respiratory status
B) Seizure activity
C) Urinary output
D) Fluid and electrolyte balance
Ans: A
Feedback: Acute care begins with managing ABCs. Patients may have difficulty keeping an open and clear airway secondary to decreased level of consciousness. Neurologic assessment with close monitoring for signs of increased neurologic deficit and seizure activity occurs next. Fluid and electrolyte balance must be controlled carefully with the goal of adequate hydration to promote perfusion and decrease further brain activity.
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