Question

A nurse in an emergency department is getting for a client who is to receive tissue

plasminogen activator (tPA) for the treatment of ischemic stroke. In which order should the nurse
complete the following actions? (Move the steps into the box on the right, placing them in the
selected order of performance. Use all the steps)

• Check the contradictions
• Transfer the client to this CCU
• Weigh the client
• Administer TPA

Answer 1

The correct order for a nurse preparing to administer tPA for ischemic stroke treatment is to check contraindications, weigh the client, administer tPA, and then transfer the client to the CCU. tPA must be administered promptly to dissolve the clot and restore brain function.

Step-by-step explanation:

The subject of this question is regarding the administration of tissue plasminogen activator (tPA) for the treatment of an ischemic stroke in a medical setting. To perform the task correctly, the nurse should:

1. Check the contraindications to ensure that tPA is safe to give to the client, taking into account any potential risks such as recent surgery or bleeding disorders.
2. Weigh the client because the dosage of tPA is weight-based to ensure efficacy and minimize the risk of complications.
3. Administer tPA as soon as possible after confirming eligibility, because time is critical in the treatment of stroke to help dissolve the clot and restore blood flow to the brain.
4. Transfer the client to the CCU (Critical Care Unit) after tPA administration for close monitoring and management of any potential complications.

Administration of a thrombolytic agent like tPA is a first intervention for someone who has suffered a thrombotic stroke to dissolve the clot quickly and potentially save brain tissue and function. tPA needs to be administered within a critical time window, ideally within 3-4 hours of stroke onset, for the best chances of recovery without significant disability.