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Comprehensive and Detailed Explanation:

The correct answer is A because orolingual angioedema is a recognized, potentially life-threatening adverse reaction associated with intravenous alteplase administration, especially in patients taking ACE inhibitors. Clinical signs include swelling of the lips, tongue, and larynx, causing airway obstruction and hypotension. The immediate nursing response is to halt the alteplase infusion instantly, maintain emergency airway equipment at the bedside, notify the provider, and prepare for emergency airway support, antihistamines, corticosteroids, or epinephrine. Option B is incorrect because the patient is hypotensive, not hypertensive. Option C is incorrect because increasing alteplase would worsen the hypersensitivity reaction. Option D is incorrect because topical creams are ineffective for deep angioedema. SCRN nurses maintain constant vigilance during thrombolytic infusions to identify and treat hypersensitivity emergencies.