What is the recommended approach if a patient is hypotensive during a stroke?

When a patient is hypotensive during a stroke, the recommended approach is to administer a bolus of normal saline or lactated Ringer's solution. This intervention is critical because maintaining adequate blood pressure and perfusion is essential for supporting brain function and minimizing damage during a stroke.

Hypotension can exacerbate ischemic conditions by reducing cerebral perfusion pressure, which can lead to further neurological deficits. Administering a fluid bolus is an effective way to quickly increase blood volume and improve blood pressure, ultimately enhancing blood flow to the brain.

Other options are less appropriate in this scenario. Large doses of diuretics would further decrease blood volume and blood pressure, thereby worsening the patient's condition. While transporting the patient to a stroke center is vital, it should not be the first response when hypotension is present; stabilization of blood pressure is a priority. Lastly, reducing blood pressure is contraindicated during hypotensive states, as this can lead to inadequate cerebral perfusion. Thus, administering a bolus of normal saline or lactated Ringer's is the correct approach in a hypotensive stroke patient.