A client in the emergency department is being prepared to receive tissue plasminogen activator (tPA). The nurse knows that which of the following is true regarding this medication?

The medication should be given with 5-6 hours of the onset of stroke systems

The medication is a primary treatment for haemorrhagic stroke.

The medication can be given to prevent clot formation in the context of head trauma

When given within a certain timeframe, the medication may dissolve an ischemic stroke

Answer and Explanation

The Correct Answer is D

A) "The medication should be given with 5-6 hours of the onset of stroke symptoms":
. tPA (tissue plasminogen activator) is typically given for an ischemic stroke, and it is most effective when administered within 3 to 4.5 hours of the onset of stroke symptoms. After this time frame, the risk of bleeding complications increases, and the benefits of the medication diminish significantly. Giving tPA after 6 hours is generally considered outside the therapeutic window for ischemic stroke, though some centers may extend the window based on specific criteria.

B) "The medication is a primary treatment for hemorrhagic stroke":
. tPA is contraindicated in hemorrhagic stroke because it works by dissolving clots, which could worsen bleeding in the brain. Hemorrhagic stroke occurs when there is bleeding in the brain, and administering tPA would exacerbate the bleeding, leading to more severe brain injury and complications. The primary treatment for hemorrhagic stroke is controlling bleeding, often through surgical interventions or managing blood pressure.

C) "The medication can be given to prevent clot formation in the context of head trauma":
. tPA is not used to prevent clot formation, particularly in the setting of head trauma. It is used to dissolve existing clots in cases of ischemic stroke. Administering tPA after head trauma or brain injury could lead to catastrophic complications, such as worsening bleeding, and should be avoided. The use of tPA is contraindicated in trauma-related situations unless the stroke is clearly ischemic and there are no signs of hemorrhage.

D) "When given within a certain timeframe, the medication may dissolve an ischemic stroke":
. tPA is the standard treatment for ischemic strokes (caused by a clot blocking blood flow to the brain). When administered within 3 to 4.5 hours of the onset of symptoms, tPA can dissolve the clot, improving blood flow to the affected area of the brain and potentially minimizing the damage caused by the stroke. Timely administration is critical for maximizing its benefits in reducing disability and improving outcomes.

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Correct Answer is D

Explanation

A) "If I develop a fever, I will tell my doctor at the next scheduled office appointment."
. Clients with HIV should not wait for their next scheduled appointment to report any signs of infection or complications. Fever, as well as other symptoms such as cough, fatigue, or skin rashes, may indicate a potential infection or opportunistic infection that requires immediate medical attention. Early intervention can prevent complications. Therefore, the nurse should emphasize the importance of reporting any symptoms of illness immediately to the healthcare provider.

B) "I will avoid hugging my family, so that I don't give them the virus."
. HIV is not transmitted through casual contact such as hugging, shaking hands, or sharing meals. HIV is transmitted through blood, semen, vaginal fluids, breast milk, and through needle sharing or sexual contact. It is important for patients with HIV to understand that they can continue to engage in normal daily activities and maintain close relationships with family members and friends without the fear of spreading HIV through non-bodily fluid contact.

C) "I can still have my favorite sushi occasionally as long as I wear a mask to the restaurant."
. The need to wear a mask to prevent HIV transmission is a misconception. HIV is not transmitted through food, air, or casual social interactions. The concern regarding eating sushi comes from the risk of foodborne illness, particularly for individuals with compromised immune systems, such as those with HIV. Raw or undercooked food (like sushi) can expose individuals to bacterial, viral, or parasitic infections, which are more harmful to immunocompromised clients. Safe food handling practices and avoiding raw or undercooked foods are more important than wearing a mask.

D) "I will need to take the medications even when the virus is well-controlled."
. Adherence to antiretroviral therapy (ART) is essential for people living with HIV, even when the virus is well-controlled and their viral load is undetectable. Stopping or interrupting ART can lead to drug resistance and a return of the virus. Consistent medication use is the key to preventing the progression of HIV, reducing viral transmission, and maintaining long-term health. The patient should be educated about the importance of taking ART as prescribed for life, even when feeling well, to keep the virus suppressed and prevent complications

A. "Be sure to bend at the hip, not the knee, to pick up items." B. internally rotating your leg is okay, but do not externally rotate it." C. If we need so help you roll in bed, we will roll you towards the operative side. D. You should keep your knees apart using a wedge or pillow.

Correct Answer is D

Explanation

A) "Be sure to bend at the hip, not the knee, to pick up items."
After hip replacement surgery, patients are instructed to avoid bending at the hip beyond 90 degrees, as this can dislocate the newly replaced hip. The correct guidance would be to avoid bending at the hip and instead bend at the knee when picking up items, ensuring the hip joint stays in a safe position.

B) "Internally rotating your leg is okay, but do not externally rotate it."
Internal rotation of the hip joint should also be avoided post-surgery, as it can increase the risk of dislocation. The correct teaching is to prevent both internal and external rotation of the hip to ensure the joint remains stable. Patients should be instructed to avoid twisting motions that can compromise the surgical repair.

C) "If we need to help you roll in bed, we will roll you towards the operative side."
This can place undue pressure on the newly replaced hip, potentially leading to dislocation or injury. The operative side should be kept stable and protected, so it is safer to roll the patient onto the non-operative side if necessary.

D) "You should keep your knees apart using a wedge or pillow."
It is essential to keep the knees apart, typically using a wedge or pillow between the legs. This prevents the hip from adducting (moving toward the midline) and reducing the risk of dislocation. Maintaining this position ensures the hip remains in a safe, stable alignment during the healing process.

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A client in the emergency department is being prepared to receive tissue plasminogen activator (tPA). The nurse knows that which of the following is true regarding this medication?

Nursing Test Bank

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Correct Answer is D

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Correct Answer is D

Explanation

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