A nurse is caring for a client who has pulmonary embolism and is receiving alteplase via continuous IV infusion.The nurse should monitor for which adverse effects of this medication? (Select all that apply.)

Hypotension

Bleeding

Dysrhythmias

Nausea

Fever.

Answer and Explanation

Correct Answer : B

Alteplase is a fibrinolytic agent that dissolves blood clots and restores blood flow. However, it also increases the risk of bleeding from any site, such as the nose, gums, injection sites, or internal organs. Therefore, the nurse should monitor the client for signs of bleeding, such as bruising, hematuria, hematemesis, melena, or decreased hemoglobin and hematocrit levels.

Choice A is wrong because hypotension is not a common adverse effect of alteplase. Hypotension may occur due to blood loss from bleeding or other causes, such as dehydration, sepsis, or cardiac dysfunction.

Choice C is wrong because dysrhythmias are not a common adverse effect of alteplase. Dysrhythmias may occur due to pulmonary embolism itself, which can cause hypoxia, acidosis, and increased pulmonary artery pressure.

Choice D is wrong because nausea is not a common adverse effect of alteplase. Nausea may occur due to other factors, such as anxiety, pain, or medications.

Choice E is wrong because fever is not a common adverse effect of alteplase. Fever may occur due to infection, inflammation, or other causes.

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Correct Answer is ["A","E"]

Explanation

The nurse should include headache and dyspnea as potential adverse effects of bivalirudin.According to the drug information from various sources, bivalirudin can cause common side effects such as headache, nausea, low or high blood pressure, chest pain, abdominal pain, and shortness of breath (dyspnea).

These side effects should be reported to the provider if they are severe or persistent.

Choice B is wrong because fever is not a common side effect of bivalirudin.

However, fever can be a sign of infection or an allergic reaction to the drug, which should be reported to the provider immediately.

Choice C is wrong because chest pain is not an adverse effect of bivalirudin, but rather a symptom of angina, which is one of the conditions that bivalirudin is used to treat.

Chest pain can also indicate a heart attack or other serious cardiac problems, which require immediate medical attention.

Choice D is wrong because backache is not a common side effect of bivalirudin.

However, backache can be a sign of bleeding in the kidneys or other organs, which can be a serious complication of bivalirudin therapy.

Therefore, any unusual pain or swelling in the back or abdomen should be reported to the provider as soon as possible.

A. Omeprazole B. Ranitidine C. Sucralfate D. Misoprostol.

Correct Answer is A

Explanation

Omeprazole is a proton pump inhibitor (PPI) that reduces the production of stomach acid.

Dabigatran is an anticoagulant that prevents blood clots from forming.

Both drugs can increase the risk of bleeding in the gastrointestinal tract, especially in clients with peptic ulcer disease.Therefore, they should not be used together unless absolutely necessary.

Choice B. Ranitidine is wrong because ranitidine is a histamine-2 receptor antagonist (H2RA) that also reduces the production of stomach acid, but to a lesser extent than PPIs.Ranitidine does not interact significantly with dabigatran and does not increase the risk of bleeding.

Choice C. Sucralfate is wrong because sucralfate is a mucosal protectant that forms a barrier over ulcers and protects them from acid and enzymes.Sucralfate does not affect the coagulation system and does not increase the risk of bleeding.

Choice D. Misoprostol is wrong because misoprostol is a synthetic prostaglandin that inhibits gastric acid secretion and increases bicarbonate and mucus production.

Misoprostol is used to prevent ulcers in clients who take NSAIDs, which can cause ulcers and bleeding.

Misoprostol does not interact with dabigatran and does not increase the risk of bleeding.

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A nurse is caring for a client who has pulmonary embolism and is receiving alteplase via continuous IV infusion.The nurse should monitor for which adverse effects of this medication? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who has a new prescription for bivalirudin about potential adverse effects of the drug. Which of the following effects should the nurse include? (Select all that apply.)

Correct Answer is ["A","E"]

Explanation

A nurse is reviewing the medication list of a client who is prescribed dabigatran and has a history of peptic ulcer disease. The nurse should recognize that which of the following medications can increase the risk of bleeding in this client?

Correct Answer is A

Explanation

A patient has been prescribed dabigatran (Pradaxa) for atrial fibrillation (AF). Which laboratory test should be monitored while on this medication?

A patient is ordered to start an IV continuous Heparin drip. Prior to starting the medication, the nurse would ensure what information is gathered correctly before initiating the drip? Select all that apply: *.

A nurse is caring for a client who is receiving argatroban IV for HIT and requires urgent surgery. The nurse should stop the infusion at least how many hours before the surgery?

A patient is receiving heparin therapy during hemodialysis for chronic renal failure and develops heparin-induced thrombocytopenia (HIT). The nurse anticipates that which medication will be ordered for this patient?

A nurse is caring for a client who has deep vein thrombosis and is receiving enoxaparin therapy subcutaneously once daily at home. The nurse should instruct the client to report which of the following findings immediately?

The patient has been receiving heparin therapy for deep vein thrombosis (DVT). The patient’s activated partial thromboplastin time (aPTT) result is 90 seconds (therapeutic range: 60-80 seconds). What will be included in patient care? (Select all that apply.).

A patient who has atrial fibrillation is taking warfarin and has an INR of 2.5.The patient reports having frequent headaches and asks for an over-the-counter pain reliever.The nurse will recommend which medication?