A nurse is assessing a neonate who was exposed to heroin in utero. Which of me following findings should the nurse identify as an indication that the neonate is experiencing neonatal abstinence syndrome?

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.

The nurse should include tinnitus (ringing in the ears) as an adverse effect of gentamicin in the client's teaching. Gentamicin is an aminoglycoside antibiotic commonly used to treat bacterial infections. One of the potential side effects of gentamicin is damage to the inner ear, which can lead to tinnitus.

Tinnitus is a concerning symptom as it may indicate ototoxicity, which is damage to the structures of the inner ear responsible for hearing and balance. If the client experiences tinnitus while taking gentamicin, it is essential to notify the healthcare provider immediately to assess the severity of the issue and consider appropriate interventions.

Let's go through the other options and explain why they are not adverse effects of gentamicin:

A. Urinary frequency: Urinary frequency is not a common adverse effect of gentamicin. Gentamicin primarily affects the kidneys, and its main concern is related to potential nephrotoxicity (kidney damage) rather than causing urinary frequency.

B. Constipation: Constipation is not an adverse effect typically associated with gentamicin. Gentamicin is not known to affect the gastrointestinal system or cause constipation.

C. Hypertension: Hypertension (high blood pressure) is not a known adverse effect of gentamicin. Gentamicin primarily affects the kidneys and the inner ear, as mentioned earlier, but it does not significantly impact blood pressure.