A nurse is caring for a client who has been taking warfarin and has a prothrombin time of 30 seconds and an INR of 7. Which of the following medications should the nurse anticipate the provider to prescribe?

A. Trombin (Evithrom): Incorrect: Thrombin (also known as factor IIa) is not typically used as a hemostatic drug. It is involved in the final step of the coagulation cascade, converting fibrinogen to fibrin to form a stable clot. However, it is not administered directly as a medication.

B. Aminocaproic acid (Amicar): Aminocaproic acid is an antifibrinolytic agent commonly used to control bleeding. It works by inhibiting the breakdown of fibrin clots, thus promoting hemostasis. It is particularly useful in situations where excessive bleeding occurs due to impaired clot dissolution. However, tranexamic acid is generally considered more potent and has a longer-lasting effect, making it the preferred choice in many situations.

C. Aspirin: Incorrect: Aspirin is an antiplatelet medication that inhibits platelet aggregation. While it can reduce the risk of clot formation, it is not primarily used for controlling postoperative bleeding.

D. Tranexamic acid (Cyklokapron): Correct: Tranexamic acid is another antifibrinolytic agent that helps prevent excessive bleeding. It works by blocking the breakdown of fibrin clots. Tranexamic acid is commonly used in surgical settings to manage bleeding during and after procedures.

A. Temperature of 100.8 Degrees Fahrenheit (38.2 Degrees Celsius): Fever can indicate a potential adverse reaction to the medication or may be a sign of infection, which could complicate the patient's condition. While a fever can be a sign of an infection, it's not a typical adverse effect for alteplase

B. Skin rash with urticaria: Skin rash and urticaria (hives) can indicate an allergic reaction to alteplase. Allergic reactions can range from mild to severe and may necessitate discontinuation of the medication and administration of appropriate treatment, such as antihistamines or corticosteroids, depending on the severity of the reaction but it's less common than bleeding.

C. Wheezing with labored breathing: Wheezing and labored breathing can indicate a severe allergic reaction or anaphylaxis to alteplase but again, bleeding is a more prominent concern.

D. Bruising and epistaxis: Alteplase increases the risk of bleeding due to its thrombolytic activity. Bruising and epistaxis (nosebleeds) are common manifestations of bleeding associated with alteplase therapy. Monitoring for these signs helps detect potential bleeding complications early, allowing for prompt intervention to minimize further bleeding and manage the patient's condition appropriately.