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 ["C","D","E","F"]
Explanation
A) Constipation: While constipation can occur with digoxin use, it is not a classic sign of digoxin toxicity. Therefore, it is less critical for the client to monitor this symptom specifically in relation to toxicity.
B) Dark red urine: Dark red urine is not typically associated with digoxin toxicity. This symptom could indicate other conditions, such as blood in the urine or issues with the kidneys, but it is not a direct manifestation of digoxin toxicity.
C) Bradycardia: Digoxin toxicity can lead to bradycardia, characterized by a slower than normal heart rate. The client should be instructed to monitor their pulse and report any significant changes, especially if the heart rate drops below 60 beats per minute.
D) Nausea: Nausea is a common symptom of digoxin toxicity. Clients should be aware of this and report any persistent or severe nausea, as it may indicate that the digoxin levels in their system are too high.
E) Vomiting: Vomiting is another classic sign of digoxin toxicity. Clients should be instructed to report any episodes of vomiting, as this can further complicate their condition and may require adjustment of their medication.
F) Anorexia: Anorexia, or loss of appetite, can also occur with digoxin toxicity. Clients should be advised to monitor their appetite and report any significant changes, as this can be an early indicator of toxicity.
Correct Answer is C
Explanation
A) "Acts on the beta cells within the heart and lungs to regulate cardiac rhythm.": This statement is incorrect because calcium channel blockers do not primarily act on beta cells. Instead, they block calcium channels in cardiac and smooth muscle, which affects heart contractility and conductivity.
B) "Increases heart rate and increases myocardial contractility.": Calcium channel blockers typically do the opposite; they decrease heart rate and myocardial contractility by inhibiting calcium entry into the heart muscle cells. Therefore, this statement does not accurately describe their mechanism of action.
C) "Reduces the contractility and conductivity of the heart.": This statement accurately reflects the action of calcium channel blockers. By blocking calcium entry, these medications decrease myocardial contractility and slow down electrical conduction through the heart, which can help manage dysrhythmias.
D) "Increase oxygen to the systemic circulation.": While calcium channel blockers can improve blood flow and reduce myocardial oxygen demand by decreasing heart workload, their primary action does not directly focus on increasing oxygen delivery to systemic circulation. Their primary role is in managing heart contractility and rhythm.