22. For optimal effects from thrombolytic therapy given for a brain attack (cerebrovascular accident [CVA]), treatment should be given:
22. For optimal effects from thrombolytic therapy given for a brain attack (cerebrovascular accident [CVA]), treatment should be given:
. Within 3 hours of the onset of symptoms.
. When signs of increased intracranial pressure occur.
. As pulse pressure begins to increase.
. No later than 24 hours after the onset of symptoms.
Test-Taking Tip
Think "the sooner the better."
Content Area: Adult Health, Cardiovascular; Integrated Process: Nursing Process, Implementation; Cognitive Level: Application; Client Need/Subneed: Physiological Integrity/Pharmacological and Parenteral Therapies/Medication Administration
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Answer 1 is correct because administration of therapy within 3 hours decreases the size of the stroke and improves client outcome. Answer 2 is incorrect because the typical signs of a stroke occur earlier. By the time the signs of increased intracranial pressure (ICP) are present, there has been distortion of brain centers. Answer 3 is incorrect because this is a sign of increased intracranial pressure and the Cushing response. Numbness, trouble speaking, or loss of balance would be earlier signs of brain attack. Answer 4 is incorrect because clinical research has shown that therapy is most effective when given within 3 hours after the onset of symptoms.