Neurological Disorders Q 99 - Gyan Darpan : Learning Portal
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Monday 18 April 2022

Neurological Disorders Q 99

During the first 24 hours after thrombolytic therapy for ischemic stroke, the primary goal is to control the client’s:
     A. Pulse
     B. Respirations
     C. Blood pressure
     D. Temperature

Correct Answer: C. Blood pressure

Controlling the blood pressure is critical because an intracerebral hemorrhage is the major adverse effect of thrombolytic therapy. Blood pressure should be maintained according to the physician and is specific to the client’s ischemic tissue needs and risks of bleeding from treatment. Other vital signs are monitored, but the priority is blood pressure.

Option A: Patients receiving thrombolytic therapy must undergo a constant neurologic and cardiovascular evaluation with blood pressure monitoring every 15 minutes during and after tPA infusion at least for 2 hours, then half-hourly for 6 hours and hourly for the next 16 hours after injection.
Option B: Strict BP monitoring is essential to prevent complications. Thrombolytic therapy should be stopped urgently with any signs of neurologic deterioration, and the patient should receive an emergency computed tomography (CT).
Option D: Fibrinolytic agents or any anticoagulants must be stopped immediately with any evidence of bleeding complications in a patient with ongoing fibrinolytic therapy. In the next step, supportive measures should be instituted, including volume correction and blood factor transfusion.

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