A 65-year-old client with an allergy to ibuprofen is cared for in the acute care setting following a stroke. Which information in the electronic health record is most concerning to the nurse?

• A. Aspirin 325 mg administered at 0935 by the licensed practical nurse.
• B. 0945: Client admitted following a stroke.
• C. The client has right-sided weakness. PT and OT are working with her.
• D. The provider told her she would be discharged within the next couple of days.

Answer: (D)

Discharge planning safety after an acute stroke is the main idea here. This patient is just after a stroke with new right-sided weakness and is actively participating in PT and OT, indicating ongoing rehabilitation needs and medical stability must be firmly established before leaving acute care. A plan to discharge within the next couple of days suggests the team hasn’t completed essential steps such as confirming swallowing safety, monitoring neurologic status, optimizing mobility, reconciling medications, arranging post-acute care (inpatient rehab, skilled nursing, or home health), and ensuring a safe home environment. Premature discharge can lead to safety risks at home, potential complications, or readmission. While the ibuprofen allergy and the administration of aspirin are important to monitor due to NSAID cross-sensitivity concerns and stroke prevention therapy, the immediate safety hazard is the rush to discharge before a comprehensive, safe post-acute plan is in place. The other notes—admission after stroke and ongoing rehab—reflect normal aspects of acute stroke care and rehabilitation.