Question

A client arrives at the ER exhibiting right-sided weakness and expressive aphasia of one hour duration. Several exams are ordered by the physician. Which exam should the nurse make sure is done first? A. CT scan B. \(\mathrm{CBC}\) C. Chest X-ray D. Carotid Doppler study

Short answer

Answer: A. CT scan

Step-by-step solution

Analyze the patient's symptoms

The patient has right-sided weakness and expressive aphasia, which are both sudden onset neurological symptoms. These symptoms could be indicative of a stroke, transient ischemic attack, or another neurological problem. The priority in this case is to determine the cause of these symptoms as quickly as possible in order for the appropriate treatment to be administered.

Evaluate the diagnostic value of each exam

A. CT scan: A CT (Computed Tomography) scan is a type of imaging study that can quickly provide detailed information about the structure of the brain and the presence of any abnormalities, such as bleeding, ischemia, or an infarct. In the case of a suspected stroke, a CT scan can help guide the appropriate treatment by differentiating between an ischemic (lack of blood flow) or hemorrhagic (bleeding) stroke. B. \(\mathrm{CBC}\) (Complete Blood Count): The complete blood count test is a routine blood test that measures various factors in the blood, such as red and white blood cell counts, and hemoglobin levels. While it provides valuable information about the patient's overall health, it won't help to determine the cause of the sudden onset neurological symptoms. C. Chest X-ray: A chest X-ray can help to identify lung and heart problems, such as pneumonia, heart failure, or lung cancer, but it will not provide any information about the cause of the neurological symptoms. D. Carotid Doppler study: A carotid Doppler study is an ultrasound imaging study that examines the blood flow through the carotid arteries, which supply blood to the brain. This test may help to identify carotid artery stenosis (narrowing) as a potential cause of the neurological symptoms, but it's a relatively time-consuming process and not useful in determining if the patient is having an acute stroke.

Determine the priority exam

Considering the potential causes of the patient's symptoms, as well as the diagnostic value and efficiency of each exam, the nurse should make sure that the CT scan is done first. This imaging study can quickly provide crucial information about the cause of the patient's neurological symptoms and guide appropriate treatment, especially in the case of a stroke, where time-sensitive interventions are critical to minimizing brain damage and improving the patient's outcome. Hence, the correct answer is: A. CT scan