Final answer:
The nurse should question the order for heparin sodium, as it is an anticoagulant that can worsen bleeding in the case of a hemorrhagic stroke. Thrombolytic agents are appropriate for thrombotic stroke, not hemorrhagic. For dehydration, isotonic saline is the appropriate intravenous fluid.
Step-by-step explanation:
The nurse should question the order for heparin sodium for a client with a hemorrhagic stroke. Heparin is an anticoagulant, which is contraindicated in hemorrhagic stroke because it can worsen bleeding. Conversely, dexamethasone (Decadron), methyldopa (Aldomet), and phenytoin (Dilantin) are not typically associated with increasing the risk of bleeding and might be used for other indications in the context of stroke.
In the case of thrombotic strokes, thrombolytic agents are a first-line intervention to dissolve the blood clot that is blocking blood flow to the brain. The rationale for using thrombolytics is to restore cerebral circulation as soon as possible to minimize brain damage. However, administering thrombolytics in hemorrhagic stroke would be harmful as they might increase bleeding.
It's important to use the correct type of fluids for intravenously hydrating a patient. For a dehydrated patient, an isotonic saline solution is often used because it is isotonic with respect to body fluids, maintaining balance without causing cellular damage that can result from the use of water, which is hypotonic, or saline that is hypertonic.