A Patient Admitted with Possible Stroke Has Been Aphasic for 3

question 12

Multiple Choice

A patient admitted with possible stroke has been aphasic for 3 hours and his current blood pressure (BP) is 174/94 mm Hg.Which order by the health care provider should the nurse question?

• A) Keep head of bed elevated at least 30 degrees.
• B) Infuse normal saline intravenously at 75 mL/hr.
• C) Administer tissue plasminogen activator (tPA) per protocol.
• D) Administer a labetalol (Normodyne) drip to keep BP less than 140/90 mm Hg.

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Definitions:

Nursing Diagnosis

A clinical judgment about individual, family, or community responses to actual or potential health problems/life processes, providing the basis for selecting nursing interventions.

Chest Pain

Discomfort or pain felt anywhere along the front of the body between the neck and upper abdomen, often a symptom of heart-related issues.

Evidence-Based Knowledge

Knowledge derived from research and clinical evidence rather than opinion or personal preference, used especially in healthcare practices.

Critical Thinker

An individual who actively questions assumptions, evaluates evidence, and assesses conclusions critically.