A nurse is caring for a client who received alteplase 12 hr ago following a thrombotic stroke. The nurse should monitor the client for which of the following adverse effects?

A. Hold the injector in place for 10 seconds: Holding the injector in place after administering epinephrine is not the first action the client should take. After administering epinephrine, the client should immediately seek emergency medical attention.
B. Massage the outer thigh for 10 seconds: Massaging the outer thigh is not the first action the client should take after administering epinephrine. Seeking emergency medical attention is the priority.
C. Seek immediate medical attention: After administering epinephrine for an anaphylactic reaction, the client should immediately seek emergency medical attention to receive further evaluation and treatment. Epinephrine provides temporary relief of symptoms but does not replace the need for medical evaluation and ongoing management.
D. Jab the device into the outer thigh. The client should use the epinephrine auto-injector as soon as possible after experiencing an anaphylactic reaction. The device delivers a dose of
epinephrine, which constricts blood vessels and relaxes the airways, to reverse the symptoms of anaphylaxis.

A. Laryngospasm: Laryngospasm is not a commonly associated adverse effect of alteplase administration. It is more commonly associated with airway irritants or allergic reactions.
B. Polycythemia: Polycythemia, or an abnormally high red blood cell count, is not a typical adverse effect of alteplase administration. Alteplase is a thrombolytic agent used to dissolve blood clots and is not associated with increasing red blood cell production.

C. Hemorrhage: Hemorrhage, or bleeding, is the most significant adverse effect associated with alteplase administration. Alteplase works by promoting fibrinolysis and can increase the risk of bleeding, including intracranial hemorrhage, particularly in the context of thrombolytic therapy for stroke.
D. Steatorrhea: Steatorrhea, or fatty stools, is not a commonly associated adverse effect of alteplase administration. It is more commonly associated with malabsorption disorders or pancreatic insufficiency.