An emergency department nurse caring for a client who has been diagnosed with an ischemic stroke that preceded a fall anticipates the need to initially prepare the client for:
1. Administration of t-PA (tissue plasminogen activator).
2. A CT scan (computerized tomography).
3. Full-body x-ray series.
4. Craniotomy.
Administration of t-PA (tissue plasminogen activator).
Rationale: The administration of t-PA does not affect the infarcted, necrotic core, but may revitalize the penumbra and limit the extent of damage caused by ischemic stroke, thus minimizing the effects of the stroke. A CT scan is a diagnostic tool to confirm the diagnosis of an ischemic stroke. An x-ray series is directed toward the identification of possible bone damage resulting from the fall but would not take priority over t-PA administration. A craniotomy evacuates a hematoma to relieve mass effect resulting from a hemorrhagic stroke.
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