RN Nursing · Stroke · Practice question
The client in the emergency department is diagnosed with an ischemic stroke and is being transferred to the intensive care unit. When the nurse explains this type of stroke to the family member, which statement by the family member leads the nurse to believe that the family member needs further explanation?
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"I know that dad cannot get that clot-buster because of the bleeding in the brain."
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"When dad is discharged, I will need to make sure he gets physical therapy."
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"It is good that they can start dad on medications to thin the blood."
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"I understand that a blood clot may have caused dad's stroke."
Answer & explanation
Correct: "I know that dad cannot get that clot-buster because of the bleeding in the brain."
An ischemic stroke occurs when a blood clot or thromboembolism blocks cerebral blood flow; it does not involve bleeding in the brain — that description applies to a hemorrhagic stroke. The family member's statement that the father cannot receive thrombolytics (the "clot-buster") because of bleeding in the brain reflects a critical misunderstanding. Thrombolytics such as alteplase are actually indicated for ischemic stroke (when given within the appropriate time window and after ruling out hemorrhage), not contraindicated because of it. Bleeding in the brain would be the contraindication for thrombolytic therapy, but with an ischemic stroke there is no hemorrhage — the problem is a clot, not blood. This statement therefore indicates the family member incorrectly believes an ischemic stroke involves intracranial bleeding, which is false. The other statements are appropriate: physical therapy is indeed part of stroke rehabilitation, anticoagulant or antiplatelet medications are used in ischemic stroke management to reduce further clot formation, and a blood clot as the causative mechanism is correct for ischemic stroke. Identifying the statement that indicates a misunderstanding is essential so the nurse can provide correct clarification and prevent confusion about treatment options.
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