What nursing intervention is essential for the client receiving alteplase?

• A. Administer vitamin K.
• B. Monitor liver enzymes.
• C. Assess for reperfusion dysrhythmias.
• D. Monitor blood pressure and stop the medication if blood pressure drops below 110 systolic.

Answer: (C)

When a client receives alteplase, the clot is dissolved and blood flow to previously ischemic tissue is restored. This reperfusion can disrupt the electrical stability of the heart and brain, leading to reperfusion dysrhythmias. Continuous ECG monitoring during and after thrombolysis is essential because detecting these rhythm disturbances early allows immediate intervention to prevent a life-threatening event. While bleeding risk and blood pressure control are also important considerations with thrombolytics, the most critical nursing action tied to the reperfusion process itself is vigilant rhythm monitoring to catch sudden dysrhythmias as perfusion is restored.