The nurse is caring for a client who currently has a deep vein thrombosis. Which of the following medications would be administered to lyse existing clots? (Select All that Apply.)
Aspirin
Heparin
warfarin (Coumadin)
alteplase (Activase)
anistreplase (Eminase)
Correct Answer : D,E
A) Aspirin: While aspirin is an antiplatelet medication that can help prevent further clot formation, it does not have thrombolytic properties and does not directly lyse existing clots. Therefore, it is not appropriate for this purpose.
B) Heparin: Heparin is an anticoagulant used to prevent the extension of existing clots and reduce the risk of new clots forming, but it does not dissolve existing clots. It helps manage deep vein thrombosis but does not have thrombolytic activity.
C) Warfarin (Coumadin): Warfarin is an oral anticoagulant that is used to prevent new clot formation and the growth of existing clots. However, like heparin, it does not actively lyse or dissolve existing clots.
D) Alteplase (Activase): This medication is a thrombolytic agent that actively dissolves blood clots by activating plasminogen to plasmin, leading to clot breakdown. It is appropriate for use in cases of deep vein thrombosis when clot lysis is indicated.
E) Anistreplase (Eminase): Similar to alteplase, anistreplase is another thrombolytic agent used to lyse existing clots. It acts by converting plasminogen to plasmin, effectively breaking down fibrin in clots, making it suitable for the treatment of deep vein thrombosis.
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Correct Answer is D
Explanation
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
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.