What is a key nursing action when giving alteplase?

When administering alteplase, a tissue plasminogen activator used primarily for the management of acute ischemic stroke, one of the key nursing actions is to monitor for changes in level of consciousness. This is crucial because changes in consciousness can indicate a potential complication, such as intracranial hemorrhage or other neurological changes that may arise as a result of the rapid restoration of blood flow to the brain.

Alteplase works by dissolving the clot that is blocking blood flow, which is essential for restoring function after an ischemic event. However, as the medication acts, it can also lead to bleeding complications, particularly within the brain. Therefore, closely observing the patient's neurological status and any changes in consciousness allows the nurse to detect such complications early and implement timely interventions.

While monitoring blood pressure, checking for bleeding, and monitoring heart rate are all important aspects of patient assessment and safety, the specific emphasis on level of consciousness reflects the acute nature of administering alteplase and the high risk of neurologic deterioration in this patient population.