What should be done to reassess a patient’s eligibility for fibrinolytic therapy?

Reassessing a patient’s eligibility for fibrinolytic therapy primarily involves evaluating their neurological status. A repeat neurological examination can help identify any changes that may affect the appropriateness of administering fibrinolytics, particularly in cases of stroke. For example, it helps to determine the presence or absence of contraindications such as a worsening clinical picture indicating a more severe hemorrhage or other neurological issues that may arise after initial presentation.

In contrast, ordering a chest X-ray would not directly provide relevant information about the patient's current neurological status and, therefore, is not a key part of reassessing eligibility for fibrinolytics. Similarly, initiating a blood transfusion is unrelated to determining whether a patient should receive fibrinolysis; it addresses other aspects of patient care. Consulting an internist might be appropriate for overall medical management but does not specifically assess the neurological condition that impacts fibrinolytic therapy decisions.