Case Steven Q11: What actions should be avoided during the 24 hours following intravenous thrombolysis (tPA) administration?

Correct Answers: B. Administering intramuscular injections C. Inserting a nasogastric tube D. Aggressively lowering blood pressure Explanation: Actions to Avoid: Administering Intramuscular Injections: Intramuscular injections should be avoided in the 24 hours following thrombolysis due to the increased risk of bleeding. This type of injection can cause bleeding complications and is generally contraindicated in the immediate post-thrombolysis period. Inserting a Nasogastric Tube: Inserting a nasogastric tube can also increase the risk of bleeding and should be avoided within the first 24 hours after thrombolysis. This procedure can cause trauma to the nasal or esophageal mucosa and potentially lead to bleeding complications. Aggressively Lowering Blood Pressure: While controlling blood pressure is important, it should not be done aggressively immediately after thrombolysis. Sudden drops in blood pressure can decrease cerebral perfusion and worsen the patient’s condition. Blood pressure should be managed cautiously to avoid complications. Action That Can Be Done: Changing the Urethral Catheter: If necessary, changing the urethral catheter is generally safe and can be done with appropriate precautions. It is not typically associated with increased bleeding risk compared to other invasive procedures. Monitoring for Swallowing Difficulties and Initiating Rehabilitation: Checking for swallowing difficulties is crucial as stroke patients are at high risk for dysphagia, which can lead to aspiration and pneumonia. Rehabilitation should begin as soon as possible to support recovery and improve functional outcomes.