Which of the following is a contraindication to administering tPA in stroke patients?

Administering tPA (tissue plasminogen activator) in the context of acute ischemic stroke is a critical decision that has specific contraindications to ensure patient safety and treatment efficacy. Hypertension is a significant contraindication because high blood pressure can increase the risk of bleeding, particularly intracranially, during or after the administration of tPA. The ideal blood pressure threshold prior to administering tPA is usually less than 185/110 mmHg, and if the patient's blood pressure exceeds this threshold, it may be necessary to manage and lower it before considering the use of thrombolytic therapy.

In contrast, anxiety, dehydration, and headache are not specific contraindications for tPA administration. While they may be relevant in a broader clinical context, they do not carry the same level of risk for adverse effects associated with thrombolytic therapy as elevated blood pressure does. Therefore, it is crucial for healthcare providers to be aware of hypertension as a contraindication, as it directly influences the safety of tPA use in stroke patients.