A nurse is preparing to administer desipramine 225 mg PO daily to a client who has depression. Available is desipramine 75 mg tablets. How many tablets should the nurse administer? (Round to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Stroke is an acute cerebrovascular disorder characterized by sudden neurological deficit due to cerebral ischemia or hemorrhage. Early recognition tools prioritize rapid bedside screening of facial asymmetry, motor weakness, and speech impairment to expedite thrombolytic therapy and reduce irreversible neuronal damage within the therapeutic window.

Rationale:

A. Glasgow Coma Scale assesses level of consciousness through eye opening, verbal response, and motor response. It is useful in trauma and coma evaluation but lacks sensitivity for focal neurological deficits of acute stroke and does not rapidly screen specific cerebrovascular symptoms.

B. FAST is a validated stroke screening tool evaluating facial droop, arm weakness, speech disturbance, and time of onset. It enables rapid prehospital and emergency identification of acute stroke, facilitating immediate activation of stroke pathways and urgent neuroimaging and thrombolysis.

C. ABC refers to airway, breathing, and circulation assessment. It is a primary survey tool for life-threatening emergencies but does not evaluate focal neurological deficits or specific stroke symptoms, making it unsuitable for rapid stroke identification despite critical resuscitation relevance.

D. NIHSS is a comprehensive stroke severity scale assessing multiple neurological domains including consciousness, gaze, motor strength, and language. It is detailed and useful for prognosis and monitoring but is time-consuming and not designed for rapid initial stroke screening.

Clinical deterioration involves progressive impairment in hemodynamic stability, oxygenation, neurologic status, and tissue perfusion caused by acute pathophysiologic changes. Early recognition of altered vital signs, mental status decline, tachypnea, and hypoxemia reduces morbidity, prevents cardiopulmonary arrest, and improves survival outcomes.

Rationale:

A. Family notification is important for communication and emotional support but does not represent the nurse’s immediate priority during physiologic decline. Acute deterioration requires urgent clinical intervention before nonessential communication. Delaying assessment and intervention increases risk of hypoxia and irreversible organ dysfunction.

B. Rapid recognition and immediate intervention are essential nursing responsibilities during clinical deterioration. Nurses continuously monitor physiologic indicators, identify subtle status changes, activate emergency responses, and initiate timely interventions. Early escalation prevents progression to respiratory failure and cardiovascular collapse while improving patient safety outcomes.

C. Waiting passively for provider orders delays critical interventions and contradicts safe nursing practice standards. Nurses must use clinical judgment, initiate rapid assessment, and activate institutional emergency protocols when deterioration occurs. Delayed response increases risk of multisystem failure and severe hemodynamic compromise.

D. Documentation is legally and clinically necessary but should occur after immediate stabilization measures are initiated. Prioritizing charting before intervention compromises patient safety during rapidly changing physiologic conditions. Immediate treatment of airway instability and impaired circulatory status takes precedence over recording findings.