An emergency department nurse is caring for a patient who has been diagnosed with an evolving ischemic stroke. The nurse anticipates preparing the patient and family for which initial medical intervention?
1. Craniotomy
2. Administration of t-PA (tissue plasminogen activator)
3. Full-body X-ray series
4. Watchful waiting over the next 24 hours
2
Rationale 1: A craniotomy evacuates a hematoma to relieve mass effect resulting from a hemorrhagic stroke.
Rationale 2: 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.
Rationale 3: There is no indication that full-body X-rays are required.
Rationale 4: If an ischemic stroke is evolving, watchful waiting will allow it to progress.
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