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 ["A","C","D"]
Explanation
A) Masking of hypoglycemia: Propranolol can mask the symptoms of hypoglycemia, such as tachycardia, which is important for clients with diabetes to be aware of. This means that while they may have low blood sugar, they might not experience the typical warning signs due to the medication's effects on the autonomic nervous system.
B) Tachycardia: Propranolol is a beta-blocker that is used to reduce heart rate and blood pressure. Therefore, tachycardia is not a side effect associated with this medication; in fact, it generally works to prevent this condition.
C) Bradycardia: Bradycardia, or a slow heart rate, is a common side effect of propranolol due to its action on beta-adrenergic receptors. Clients should be educated about monitoring their heart rate and reporting any significant drops.
D) Orthostatic Hypotension: This is a potential side effect of propranolol, especially when starting the medication or increasing the dose. Clients should be advised to rise slowly from sitting or lying positions to minimize the risk of dizziness or fainting.
E) Hypertension: Propranolol is prescribed to manage hypertension, so it should not be expected as a side effect. In fact, it is intended to lower blood pressure, and clients should be educated that they should not experience increased hypertension while taking this medication.
Correct Answer is A
Explanation
A) Hypokalemia: Hypokalemia, or low potassium levels, significantly increases the risk of digoxin toxicity. Since digoxin competes with potassium for binding at the sodium-potassium ATPase site in the heart, low potassium levels can lead to increased digoxin effects and toxicity. Therefore, it is crucial to monitor potassium levels and correct any deficiencies before administering digoxin.
B) Hyperkalemia: While hyperkalemia is a serious concern and can also affect digoxin therapy, it usually results in decreased effectiveness of digoxin rather than increasing toxicity. Elevated potassium levels can diminish the drug's positive inotropic effect.
C) Hypocalcemia: Although calcium levels can influence cardiac function, hypocalcemia is not directly related to digoxin toxicity. Monitoring calcium is important for overall cardiac health, but it is not the primary focus when assessing the risk for digoxin toxicity.
D) Hypernatremia: Elevated sodium levels do not have a direct impact on the efficacy or toxicity of digoxin. While sodium levels are essential to monitor for overall health, they are not critical in the context of digoxin administration and toxicity risk.