One element of ischemic CVAs that some nurses may not know about is blood pressure parameters in the acute post CVA period. Filho and Mullen (2018) state that for ischemic CVAs when TPA is not used, permissive hypertension is beneficial to outcomes up to 220mmHg systolic and 120mmHg diastolic because it allows for perfusion of the cerebral tissue affected by the ischemic arteries. In the event that TPA was used, the authors advise reducing the upper limits to 180/105mmHg. The authors also state that if the patient was on antihypertensive medications prior to the CVA, then these medicines could be restarted if the blood pressure was over 140/90mmHg.
So the next time you have a patient s/p ischemic CVA, think twice before calling the doctor and let the blood pressure reach these high limits because it is actually a good thing.
Filho, J. O., & Mullen, M. T. (2018). Initial assessment and management of acute stroke. UpToDate . Retrieved from https://www.uptodate.com/contents/initial-assessment-and-management-of-acute-stroke