Thrombolytics – Flashcards

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question
What is the main difference between anticoagulant drug therapy and thrombolytic drug therapy?
answer
Anticoagulants are given to prevent thrombus formation. Thrombolytic drugs are given to remove thrombi that have already formed.
question
What substance does alteplase combine with first in order to form an active complex?
answer
Plasminogen
question
Where is alteplase excreted?
answer
Kidney (urine)
question
Which documented assessment finding by the nurse is a relative contraindication to thrombolytic therapy?
answer
History of dementia
question
Mr. Zappetti is complaining of pain at the venipuncture site. Which pain medication would be appropriate to administer after thrombolytic therapy?
answer
Acetaminophen
question
Which conditions are contraindicated for thrombolytic therapy?
answer
1. Recent cerebrovascular accident (CVA) 2. Active bleeding, severe hypertension 3. Anticoagulant therapy 4. Brain tumor
question
During thrombolytic therapy, an increased pulse rate followed by decreased blood pressure usually indicates which emergency?
answer
Blood loss and impending shock
question
The nurse should instruct a patient taking alteplase to immediately report which symptom(s) to the health care provider?
answer
1. Nosebleeds 2. Tarry stools 3. Bleeding gums
question
Why is it important for the nurse to inquire about cultural practices when educating patients about Western health care?
answer
Nurses should seek to incorporate patients' practices and values in patient education.
question
Alteplase is a large molecule that must be administered by which route?
answer
Intravenous (IV)
question
Where does alteplase metabolism occur?
answer
Liver
question
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?
answer
Thrombolytic drugs are used to remove thrombi that have already formed.
question
What is the duration of action with alteplase?
answer
3 hours
question
A patient on thrombolytic therapy experiences several bleeding. The nurse anticipates the administration of which medication?
answer
Aminocoproic acid
question
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?
answer
Notify the health care prescriber.
question
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?
answer
Acetaminophen
question
How often should the nurse assess the patient for active bleeding during the first 24 hours?
answer
Every hour
question
Which laboratory values are critical for the nurse to check before administering thrombolytic therapy?
answer
Hematocrit, platelet count, blood glucose, thrombin time, prothrombin time, activated partial thromboplastin time, and fibrinogen levels
question
What side effects should the nurse teach the patient to report during thrombolytic therapy?
answer
1. Rapid heartbeat 2. Nausea 3. Lightheadedness 4. Dizziness
question
How can the nurse assess comprehension in the patient receiving education about thrombolytic drug therapy?
answer
The nurse should ask the patient to repeat back the teaching offered by the nurse.
question
A nurse has provided instructions to a patient who received alteplase. Which statement indicates that the patient needs further instruction?
answer
"I am going to shave this afternoon."
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