Which of the following is not a contraindication for the use of tissue plasminogen activator (PA) in the treatment of stroke?

A. "Promptly change out of wet clothing such as bathing suits after use":
This is a key recommendation for preventing urinary tract infections (UTIs), especially in women. Wet clothing, such as swimsuits or damp exercise clothes, creates a warm, moist environment that encourages bacterial growth, particularly in the genital and perineal areas. Changing out of wet clothing promptly helps reduce the risk of bacteria entering the urinary tract, which is an important preventive measure for recurrent UTIs.

B. "Buy synthetic underwear rather than cotton fabric":
This statement is incorrect. Cotton underwear is recommended because it is breathable and helps keep the genital area dry, reducing the likelihood of bacterial growth. Synthetic fabrics, on the other hand, trap moisture and heat, creating an environment where bacteria can thrive, increasing the risk of UTIs. Therefore, wearing cotton underwear is advised rather than synthetic fabric.

C. "Be sure to empty your bladder every 6-8 hours":
This recommendation is somewhat inaccurate. To prevent UTIs, it is essential to empty the bladder more frequently than every 6-8 hours, especially if the person feels the urge to urinate. Holding urine for long periods can increase the risk of bacterial growth in the urinary tract. It is generally recommended to urinate at least every 3-4 hours during the day to prevent urine stagnation and reduce the risk of infection.

D. "Try to drink 500-1000 ml of fluid per day":
This fluid intake recommendation is too low. To prevent UTIs, a higher fluid intake is necessary—typically 2-3 liters (2000-3000 mL) of fluid per day. Adequate hydration helps ensure frequent urination, which flushes out bacteria from the urinary tract. Consuming only 500-1000 mL of fluid per day is insufficient and would likely increase the risk of UTIs due to less frequent urination and less flushing of the urinary system.

A) "Administer IV hydralazine and monitor blood pressure":
. The patient's elevated blood pressure (172/92 mmHg), along with headaches and blurred vision, could indicate a hypertensive emergency, a serious condition where extremely high blood pressure can cause acute organ damage. Hydralazine is a common intravenous antihypertensive medication used to lower blood pressure quickly in these situations. The nurse should administer hydralazine as prescribed and closely monitor the blood pressure to prevent complications like stroke, heart failure, or kidney damage. Blood pressure management is the priority, as the patient's symptoms are likely related to the elevated BP.

B) "Administer oxygen at 10 liters/minute by non-rebreather mask":
. While oxygen therapy may be appropriate for patients with respiratory distress or hypoxia, the patient's SpO2 is 97% on room air, indicating that there is no immediate oxygenation issue. Administering oxygen unnecessarily could lead to oxygen toxicity, and it is not the priority in this case. The patient's main concern is their elevated blood pressure, which requires urgent management.

C) "Administer acetaminophen 650 mg PO re-check temperature":
. While headaches are one of the patient's complaints, there is no indication of fever (the temperature is 98.6°F). Administering acetaminophen would be appropriate for pain relief, but it is not the priority in this case. The elevated blood pressure and potential hypertensive emergency are the primary issues that need to be addressed first.

D) "Infuse 0.9% sodium chloride at 120 mL/hour":
. Normal saline (0.9% sodium chloride) is typically used for hydration, but there is no indication that the patient is dehydrated or that intravenous fluids are the priority. In cases of hypertensive emergency, the goal is to lower blood pressure using antihypertensive medications, not to infuse fluids. Fluid administration could potentially worsen the situation if the elevated blood pressure is not addressed first.