A client who has just experienced a pulmonary embolism is administered alteplase (Activase). Which of the following side effects associated with this medication would the nurse assess for?
pancytopenia
Hypertension
Hypokalemia
Internal bleeding
The Correct Answer is D
A) Pancytopenia: While some medications can cause pancytopenia, it is not a common or direct side effect of alteplase. This condition involves a reduction in red blood cells, white blood cells, and platelets, and is not typically associated with thrombolytics.
B) Hypertension: Alteplase is not known to cause hypertension. In fact, the goal of administering alteplase in the context of a pulmonary embolism is to dissolve the clot and restore normal blood flow, which may help stabilize blood pressure.
C) Hypokalemia: This condition, characterized by low potassium levels, is not a common side effect of alteplase. There are other medications that may cause electrolyte imbalances, but alteplase itself is not typically linked to hypokalemia.
D) Internal bleeding: This is a significant risk associated with alteplase, as it is a thrombolytic agent that dissolves clots. The nurse should closely monitor for signs of internal bleeding, such as changes in vital signs, unexplained bruising, or blood in urine or stool. This is the most critical side effect to assess for in a client receiving alteplase
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Correct Answer is D
Explanation
A) Atenolol: This is a beta-blocker that can be used for various cardiac conditions, including hypertension and certain arrhythmias, but it is not typically the first-line treatment for acute life-threatening ventricular dysrhythmias in the emergency setting.
B) Lisinopril: This medication is an ACE inhibitor primarily used to manage hypertension and heart failure. It does not address acute ventricular dysrhythmias and would not be appropriate for immediate use in this scenario.
C) Adenosine: While adenosine is effective for certain types of supraventricular tachycardia, it is not indicated for life-threatening ventricular dysrhythmias. It has a very short duration of action and is not the drug of choice in this context.
D) Procainamide: This antiarrhythmic medication is specifically used to treat life-threatening ventricular dysrhythmias. It works by stabilizing the cardiac membrane and is indicated in emergency situations to manage these types of arrhythmias. Therefore, preparing procainamide is the most appropriate action for the nurse in this scenario.
Correct Answer is A
Explanation
A) Heparin induced thrombocytopenia (HIT): Argatroban is an indirect thrombin inhibitor specifically used for anticoagulation in patients with HIT. This condition involves a significant drop in platelet counts due to heparin therapy, and argatroban is an appropriate alternative for preventing thrombosis in these patients.
B) Ventricular Dysfunction: While managing anticoagulation may be important in patients with ventricular dysfunction, this condition does not specifically necessitate the use of argatroban. Other anticoagulants may be used based on the clinical situation.
C) Myocardial infarction: Although anticoagulation may be warranted in the setting of a myocardial infarction, argatroban is not specifically indicated for this condition. Other antithrombotic therapies, such as aspirin or heparin, are more commonly used.
D) Hepatotoxicity: Argatroban is metabolized in the liver, so caution is warranted in patients with liver dysfunction. Hepatotoxicity itself would not be a reason to use argatroban; rather, it may require close monitoring or adjustment of dosage.