What sign after thrombolytic therapy would most alarm the nurse?

Facial drooping following thrombolytic therapy would be highly alarming to the nurse. This sign may indicate potential complications such as a stroke, or a transient ischemic attack (TIA), which can occur as a result of thrombolytic therapy. The therapy aims to dissolve clots obstructing blood flow to the heart; however, it carries risks such as intracranial hemorrhage, particularly if there is an underlying issue like a cerebral aneurysm or severe hypertension. Facial drooping is a classic symptom of neurological deficits and warrants immediate evaluation and intervention.

In contrast, a minor backup of blood in the IV tubing is usually not a critical concern and can likely be managed without urgency. Similarly, a partial thromboplastin time (PTT) of 68 seconds, while elevated, does not necessarily indicate a crisis on its own; it could be monitored closely as part of the expected pharmacologic effect of thrombolytics. Lastly, a report of chest pressure during dye injection, while it may require attention, does not carry the immediate risk of life-threatening complications that facial drooping does. Therefore, monitoring for neurological signs is critical in the post-thrombolytic therapy phase.