A nurse admits a client who has a subarachnoid hemorrhage and expects to administer medication to decrease intracranial pressure (ICP). Which of the following medications should the nurse administer?

Choice A rationale

Maintaining systolic BP between 136 and 140 mm Hg is generally considered prehypertensive or mildly hypertensive. For a client who has experienced a TIA, tighter blood pressure control is typically recommended to minimize the risk of future cerebrovascular events.

Choice B rationale

Maintaining systolic BP between 141 and 145 mm Hg indicates Stage 2 hypertension. This range is far too high for a client with a history of TIA, as uncontrolled hypertension significantly increases the risk of recurrent strokes and other cardiovascular complications.

Choice C rationale

For a client with hypertension who has experienced a TIA, maintaining systolic BP between 120 and 129 mm Hg is the recommended target. This goal aims to reduce the risk of future cerebrovascular events by minimizing the strain on arterial walls and promoting optimal cerebral perfusion.

Choice D rationale

Maintaining systolic BP between 130 and 135 mm Hg is still considered elevated. While better than higher ranges, the optimal target for secondary prevention of stroke after a TIA is generally lower to provide greater cardiovascular protection and reduce the likelihood of another ischemic event.

Choice A rationale

Sickle cell anemia is a genetic disorder affecting hemoglobin, leading to abnormally shaped red blood cells and chronic hemolysis. It is not classified as an autoimmune disease, where the immune system mistakenly attacks healthy body tissues. Autoimmune diseases involve a dysfunctional immune response against self-antigens.

Choice B rationale

Ferritin is a protein that stores iron, and low ferritin levels indicate iron deficiency anemia. While individuals with sickle cell anemia can sometimes have co-existing iron deficiency, their chronic fatigue is primarily due to the ongoing hemolysis and resulting anemia rather than solely a low ferritin level.

Choice C rationale

Gastrointestinal bleeding can cause anemia and fatigue due to blood loss. However, while complications of sickle cell anemia can affect various organ systems, a gastrointestinal bleed is not the primary or universal reason for the chronic fatigue experienced by individuals with the condition. The fatigue is systemic due to the underlying pathology.

Choice D rationale

Sickle cell anemia causes chronic hemolytic anemia, meaning that red blood cells are prematurely destroyed, leading to a consistently lower number of circulating red blood cells than normal. Red blood cells are responsible for oxygen transport, so fewer healthy red blood cells result in reduced oxygen delivery to tissues, causing persistent fatigue.