Question

A client having an ischemic stroke arrives at the emergency department. The health care provider prescribes tissue plasminogen activator (tPA). Which client statement would be most important to clarify before administering tPA?
1. "I can't believe this is happening right after my stomach surgery."
2. "I had a concussion after a car accident a year ago."
3. "I started noticing my right arm becoming weak approximately an hour ago."
4. "I stopped taking my warfarin 4 weeks ago."

Answer 1

1. "I can't believe this is happening right after my stomach surgery."

Explanation:

When blood flow is blocked due to formation of clots or other factors, the brain does not receive enough blood due to which there is obstruction in the flow of energy. This causes Ischemic Stroke in patients and must be treated immediately.

Tissue plasminogen activator (tPA) dissolves blood clots and restores perfusion in clients with ischemic stroke.

It must be administered within a 3-4.5 hour window from appearance of symptoms for effective healing.

The nurse assesses for contraindications to tPA due to the risk of hemorrhage.

No history of intracranial hemorrhage or active bleeding should be present in the case of this patient.