Which statement is accurate about the recommendations for BP management after an ischemic stroke?

The BP must be lower than 130/70 mm Hg to receive fibrinolytic agents.

Elevated BPs are expected after a stroke, and drug therapy should be initiated.

A lower BP is a protective response to maintain cerebral perfusion.

Drugs to lower BP are recommended if the BP is 220/120 mm Hg or higher

Answer and Explanation

The Correct Answer is D

A.   The BP must be lower than 180/105 mm Hg to receive fibrinolytic agents, not 130/70 mm Hg.
B.   Elevated BPs are common immediately after a stroke, but drug therapy to lower BP is not initiated unless it reaches high levels (typically > 220/120 mm Hg).
C.   A lower BP does not act as a protective response; maintaining a higher BP can be necessary initially after a stroke to ensure adequate cerebral perfusion.

D.   If BP is 220/120 mm Hg or higher after ischemic stroke, aggressive antihypertensive therapy is initiated to reduce the risk of hemorrhagic transformation and other complications.

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Correct Answer is B

Explanation

A. Placing the client in a supine position may increase ICP; the nurse should elevate the head of the bed to 30 degrees to reduce pressure.
B. Log rolling to reposition the client helps maintain spinal alignment and prevent further injury without increasing ICP.
C. Coughing and deep breathing should be avoided as they can increase ICP.
D. A warming blanket could cause vasodilation and worsen ICP.

A. Increased ICP B. Decreased cerebral blood flow (CBF) C. Increased cerebral perfusion pressure (CPP) D. Normal intracranial pressure

Correct Answer is B

Explanation

A. Increased ICP would be a concern when the MAP falls below 70 mm Hg because reduced blood pressure can lead to inadequate cerebral blood flow and worsen ICP.
B. Decreased cerebral blood flow (CBF) is also a concern with low MAP, but the priority is maintaining MAP at a sufficient level to ensure adequate perfusion.
C. Increased CPP is unlikely with a low MAP, as CPP is a product of MAP and ICP.
D. Normal ICP would be a good outcome; however, with a low MAP, the nurse should be concerned about insufficient cerebral perfusion and the risk of increased ICP.

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Which statement is accurate about the recommendations for BP management after an ischemic stroke?

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