A patient who has had TPA administered for an acute myocardial infarction (AMI) is found to be disoriented. What should the nurse do next?

In a situation where a patient has received tissue plasminogen activator (TPA) for an acute myocardial infarction (AMI) and is subsequently found to be disoriented, the priority is to assess the potential side effects and complications associated with TPA. One significant risk of TPA administration is the potential for bleeding, including intracranial bleeding, which could lead to changes in consciousness such as disorientation.

Discontinuing TPA is warranted if there are signs of a possible bleeding complication that may be affecting the patient's neurological status. This action helps prevent further complications and allows for a thorough investigation into the cause of the disorientation. Immediate intervention is crucial in this context, as timely management can significantly affect patient outcomes.

Monitoring vital signs and administering oxygen are important components of patient care, but they do not address the potential life-threatening complications associated with TPA administration directly. Calling a rapid response team may be necessary depending on the severity of the patient's condition, but the first step should be to discontinue TPA to mitigate potential harm.