A nurse in the emergency department is planning care for a client who had a myocardial infarction and is receiving thrombolytic therapy with an WV infusion of alteplase. Which of the following interventions should the nurse include in the plan?

Administer aspirin instead of acetaminophen for fever

Ambulate the client as often as tolerated

Administer a sodium phosphate enema for constipation

Monitor for changes in level of consciousness

Answer and Explanation

The Correct Answer is D

When planning care for a client who had a myocardial infarction and is receiving thrombolytic therapy with an IV infusion of alteplase, the nurse should include the intervention of monitoring for changes in the client's level of consciousness.

Alteplase is a thrombolytic medication used to break down blood clots in certain medical emergencies, such as acute myocardial infarction (heart attack) or ischemic stroke. One of the potential complications of thrombolytic therapy, including alteplase, is bleeding. The medication's action of breaking down blood clots can also affect the body's natural clotting mechanisms, increasing the risk of bleeding.

Bleeding in the brain is a severe and potentially life-threatening complication associated with thrombolytic therapy. Therefore, it is essential for the nurse to closely monitor the client for any signs of intracranial bleeding, such as changes in the level of consciousness, confusion, severe headache, slurred speech, or weakness on one side of the body.

Let's go through the other options:

A. Administer aspirin instead of acetaminophen for fever: While aspirin is commonly used in the management of myocardial infarction, it is not specifically indicated for fever. Acetaminophen is the preferred antipyretic medication for fever management in most cases, and it does not interfere with the action of thrombolytic therapy.

B. Ambulate the client as often as tolerated: While early ambulation is beneficial for clients with myocardial infarction, it may not be appropriate during thrombolytic therapy. Thrombolytic therapy carries an increased risk of bleeding, and ambulation may be limited or contraindicated during the treatment period, depending on the client's overall condition and bleeding risk.

C. Administer a sodium phosphate enema for constipation: The administration of a sodium phosphate enema is not a specific intervention related to thrombolytic therapy or myocardial infarction. Bowel management is important for client comfort and overall well-being, but it is not a priority intervention in the immediate care of a client undergoing thrombolytic therapy.

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Correct Answer is ["0.12"]

Explanation

To calculate the rate at which the IV pump should be set to deliver dopamine, we need to determine the total amount of dopamine in the infusion and divide it by the desired dose per minute.

Given:

Dopamine concentration: 400 mg in 250 mL

Desired dose: 5 mcg/kg/min

Patient weight: 220 lb

First, we need to convert the patient's weight from pounds to kilograms:

220 lb ÷ 2.2 = 100 kg

Next, we need to calculate the total amount of dopamine needed per minute:

5 mcg/kg/min × 100 kg = 500 mcg/min

Now, we need to convert the dopamine dose from mcg to mg:

500 mcg/min ÷ 1000 = 0.5 mg/min

To determine the infusion rate in mL/hr, we divide the dose in mg/min by the dopamine concentration in the infusion solution:

0.5 mg/min ÷ 250 mL = 0.002 mL/min

Finally, we convert the infusion rate from mL/min to mL/hr by multiplying by 60:

0.002 mL/min × 60 min = 0.12 mL/hr

Therefore, the nurse should set the IV pump to deliver 0.12 mL/hr.

A. The client has a history of alcohol use disorder but is currently sober B. The client recently had a norovirus infection C. The client smokes one pack of cigarette per day D. The client has a history of rheumatoid arthritis

Correct Answer is C

Explanation

Smoking is a known risk factor for the development of aspirin-induced ulcers. It can increase the risk of gastrointestinal bleeding and compromise the integrity of the gastric mucosa. Smoking can also impair the healing process and increase the risk of complications associated with ulcers.

While the other factors mentioned in the options may have their own health implications, smoking is specifically associated with an increased risk of aspirin-induced ulcers. Therefore, the nurse should identify the client's smoking habit as a risk factor for the development of an aspirin-induced ulcer.

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A nurse in the emergency department is planning care for a client who had a myocardial infarction and is receiving thrombolytic therapy with an WV infusion of alteplase. Which of the following interventions should the nurse include in the plan?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["0.12"]

Explanation

A nurse is caring for a client who is starting to take aspirin 81 mg daily. Which of the following findings should the nurse identify as a risk factor for the client's development of an aspirin-induced ulcer?

Correct Answer is C

Explanation

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