Critical care nurses need expertise in managing hypertension in patients who have had an acute ischemic stroke. Stroke protocols include administration of alteplase (rtPA) and provide guidelines for management of hypertension; IV labetalol is often recommended. The author provides nursing considerations for management of hypertension, including administration of labetalol.

The statistics on high blood pressure and stroke are sobering: every year, about 600000 persons in the United States have a stroke (83% ischemic, 17% hemorrhagic).1 Roughly half of those persons have hypertension,1 and hypertension develops after stroke in many patients who were previously normotensive.2 In the landmark 1996 National Institute of Neurological Disorders and Stroke (NINDS) trial of recombinant tissue plasminogen activator (rtPA) in patients with stroke, 19% of the subjects were hypertensive at the time of their acute ischemic stroke; within 24 hours, that rate...

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