A client has been found unresponsive at home for an undetermined period of time. A cerebrovascular accident (CVA) is suspected, and the family is demanding a clot buster be used to restore functioning
The nurse knows that successful use of TPA in a client with CVA requires which of the following? Select all that apply. A) The symptoms are no longer evolving.
B) Presence of an ischemic stroke
C) Used concurrently with heparin therapy
D) Administer intramuscular for faster response.
E) Administer within 3 hours of onset of symptoms.
F) Administer for hemorrhagic strokes.
B, E
Feedback:
TPA is a thrombolytic agent that can limit neurologic deficits if given IV within 3 hours of onset of an ischemic CVA. Waiting for symptoms to stabilize (no longer evolve) may take days and would not be appropriate for the use of TPA. TPA is not used in conjunction with other anticoagulants and would never be used to treat a hemorrhagic stroke (promotes more bleeding).
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