Thrombolytics – Flashcards
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What is the main difference between anticoagulant drug therapy and thrombolytic drug therapy?
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Anticoagulants are given to prevent thrombus formation. Thrombolytic drugs are given to remove thrombi that have already formed.
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What substance does alteplase combine with first in order to form an active complex?
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Plasminogen
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Where is alteplase excreted?
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Kidney (urine)
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Which documented assessment finding by the nurse is a relative contraindication to thrombolytic therapy?
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History of dementia
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Mr. Zappetti is complaining of pain at the venipuncture site. Which pain medication would be appropriate to administer after thrombolytic therapy?
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Acetaminophen
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Which conditions are contraindicated for thrombolytic therapy?
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1. Recent cerebrovascular accident (CVA) 2. Active bleeding, severe hypertension 3. Anticoagulant therapy 4. Brain tumor
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During thrombolytic therapy, an increased pulse rate followed by decreased blood pressure usually indicates which emergency?
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Blood loss and impending shock
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The nurse should instruct a patient taking alteplase to immediately report which symptom(s) to the health care provider?
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1. Nosebleeds 2. Tarry stools 3. Bleeding gums
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Why is it important for the nurse to inquire about cultural practices when educating patients about Western health care?
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Nurses should seek to incorporate patients' practices and values in patient education.
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Alteplase is a large molecule that must be administered by which route?
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Intravenous (IV)
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Where does alteplase metabolism occur?
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Liver
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A patient diagnosed with pulmonary embolism is prescribed alteplase. The patient asks the nurse why an anticoagulant was not prescribed. How should the nurse respond?
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Thrombolytic drugs are used to remove thrombi that have already formed.
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What is the duration of action with alteplase?
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3 hours
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A patient on thrombolytic therapy experiences several bleeding. The nurse anticipates the administration of which medication?
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Aminocoproic acid
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A patient who has a pulmonary embolism is prescribed alteplase. The review of history reveals an ischemic stroke 4 months ago. Which action should the nurse take?
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Notify the health care prescriber.
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A patient prescribed alteplase reports a headache with pain 6 out of 10 on a numeric scale. Which medication should the nurse be prepared to administer to this patient?
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Acetaminophen
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How often should the nurse assess the patient for active bleeding during the first 24 hours?
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Every hour
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Which laboratory values are critical for the nurse to check before administering thrombolytic therapy?
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Hematocrit, platelet count, blood glucose, thrombin time, prothrombin time, activated partial thromboplastin time, and fibrinogen levels
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What side effects should the nurse teach the patient to report during thrombolytic therapy?
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1. Rapid heartbeat 2. Nausea 3. Lightheadedness 4. Dizziness
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How can the nurse assess comprehension in the patient receiving education about thrombolytic drug therapy?
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The nurse should ask the patient to repeat back the teaching offered by the nurse.
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A nurse has provided instructions to a patient who received alteplase. Which statement indicates that the patient needs further instruction?
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"I am going to shave this afternoon."
