What should be administered if SBP is 185 or greater in a stroke alert patient?

In the context of managing a stroke alert patient with a systolic blood pressure (SBP) of 185 mmHg or greater, it is crucial to lower elevated blood pressure to minimize the risk of exacerbating potential damage to the brain. The recommended course of action in this scenario is the administration of hydralazine, which is a potent antihypertensive agent. Hydralazine acts by causing vasodilation, leading to a reduction in systemic vascular resistance and, subsequently, lowering blood pressure.

Maintaining blood pressure within an optimal range is especially important in stroke management to ensure that cerebral perfusion is maintained without putting the patient at risk of further ischemic injury or hemorrhage. Hydralazine is typically used in acute settings due to its rapid onset, allowing for prompt blood pressure control.

Other options, while they may have their utility in various clinical scenarios, do not specifically target the critical need to reduce elevated blood pressure in this acute stroke context. For example, providing aspirin may be appropriate for certain types of strokes, but it does not address the immediate concern of high blood pressure that could complicate treatment. Likewise, albumin is used for volume expansion and may not have an immediate effect on blood pressure management, and labetalol, while