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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?

A.

pancytopenia

B.

Hypertension

C.

Hypokalemia

D.

Internal bleeding

Answer and Explanation

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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View Related questions

Correct Answer is A

Explanation

A) Losartan (Cozaar): This medication is an angiotensin II receptor blocker (ARB) and is often used as an alternative for patients who experience a cough due to ACE inhibitors. Unlike ACE inhibitors, ARBs do not typically cause a cough because they do not affect bradykinin levels, making losartan an appropriate choice for managing hypertension without the adverse effect of a persistent cough.

B) Hydralazine HCL (Apresoline): While hydralazine is an antihypertensive, it works through a different mechanism (direct vasodilation) and is not a first-line alternative for patients with a history of ACE inhibitor-induced cough. It's generally used in specific situations, such as severe hypertension or heart failure.

C) Furosemide (Lasix): This is a loop diuretic primarily used for conditions like heart failure or edema, rather than for the management of hypertension alone. It does not address the underlying hypertension in the same manner as ACE inhibitors or ARBs.

D) Metoprolol (Lopressor): This is a beta-blocker that can be used for hypertension, but it does not directly address the issue of cough related to ACE inhibitors. Switching to a beta-blocker may not be the best option if the client is specifically seeking to avoid the cough associated with ACE inhibitors.

Correct Answer is C

Explanation

A) Platelet counts: Monitoring platelet counts is not necessary with atorvastatin therapy. While certain medications may affect platelet levels, atorvastatin primarily targets lipid levels and does not have a significant impact on platelet function.

B) Lung function test: Lung function tests are not relevant for atorvastatin use. These tests are typically utilized for assessing respiratory conditions and are not part of the routine monitoring for cholesterol-lowering medications.

C) Liver function test: Atorvastatin can affect liver function, so it is essential to monitor liver

enzymes (such as AST and ALT) regularly. Routine liver function tests help identify any potential hepatotoxicity early, allowing for timely intervention if liver function declines.

D) Bun and creatinine levels: While monitoring renal function can be important in some contexts, it is not a routine requirement specifically for atorvastatin. However, it may be necessary in certain patient populations or if there are concerns about kidney function, but liver function tests are the primary focus with this medication.

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