A client who has atrial fibrillation is prescribed dabigatran etexilate mesylate (Pradaxa). The nurse should instruct the client to report which of the following findings immediately? (Select all that apply.)
Unusual bleeding or bruising
Blood in urine or stool
Abdominal pain or swelling
Headache or dizziness
Shortness of breath.
Correct Answer : A,B,C
Dabigatran etexilate mesylate (Pradaxa) is a medication that prevents blood clots and reduces the risk of stroke in patients with atrial fibrillation.
However, it can also cause bleeding as a side effect.
Therefore, the nurse should instruct the client to report any signs of unusual bleeding or bruising, blood in urine or stool, or abdominal pain or swelling immediately. These could indicate a serious complication such as gastrointestinal bleeding, hemorrhage, or internal organ damage.
Choice D, headache or dizziness, is not a correct answer.
Although these symptoms could be caused by dabigatran, they are not as serious or urgent as bleeding.
They could also be due to other factors such as dehydration, low blood pressure, or stress. The nurse should advise the client to monitor these symptoms and seek medical attention if they persist or worsen.
Choice E, shortness of breath, is not a correct answer.
Shortness of breath is not a common side effect of dabigatran.
However, it could be a symptom of atrial fibrillation or its complications such as heart failure or stroke. The nurse should educate the client about the signs and symptoms of these conditions and instruct them to call 911 if they experience chest pain, palpitations, fainting, or weakness.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
This is because alteplase [Activase] is a thrombolytic drug that dissolves blood clots and can cause bleeding complications, especially intracranial hemorrhage.Neurologic assessment is essential to detect any signs of bleeding in the brain, such as altered level of consciousness, headache, or focal deficits.
Choice A is wrong because applying pressure to needleless access sites after giving medications is a standard precaution to prevent bleeding and infection.It is not specific to alteplase [Activase] therapy.
Choice C is wrong because administering heparin when partial thromboplastin time (PTT) is less than 70 seconds is not recommended for patients who have received alteplase [Activase].
Heparin is an anticoagulant that can increase the risk of bleeding and should be used with caution in patients who have received thrombolytic therapy.The PTT should be monitored closely and heparin should be withheld if the PTT is above the therapeutic range.
Choice D is wrong because giving aspirin when platelet count is greater than 150,000/mm3 is not indicated for patients who have received alteplase [Activase].
Aspirin is an antiplatelet drug that can also increase the risk of bleeding and should be avoided in patients who have received thrombolytic therapy.
The platelet count should be monitored closely and aspirin should be withheld if the platelet count is below the normal range (150,000 to 450,000/mm3).
Correct Answer is B
Explanation
A history of stroke is an absolute contraindication to the administration of a thrombolytic to a patient having an acute myocardial infarction (AMI).This is because thrombolytics can increase the risk of intracranial hemorrhage and worsen the neurological outcome.
Choice A is wrong because history of hypertension is not an absolute contraindication, but a relative one.This means that the benefits of thrombolytic therapy may outweigh the risks in some cases, depending on the severity and duration of hypertension.
Choice C is wrong because history of peptic ulcer disease is also a relative contraindication, not an absolute one.Thrombolytics can increase the risk of gastrointestinal bleeding, but this can be managed with proton pump inhibitors or histamine-2 blockers.
Choice D is wrong because history of diabetes mellitus is not a contraindication at all to thrombolytic therapy.In fact, some studies have shown that diabetic patients with AMI may benefit more from thrombolytic therapy than non-diabetic patients.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.