A patient is receiving alteplase (Activase), a thrombolytic drug. The nurse monitors the patient for which of the following possible adverse effects?
Temperature of 100.8 Degrees Fahrenheit (38.2 Degrees Celsius)
Skin rash with urticaria
Wheezing with labored breathing
Bruising and epistaxis
The Correct Answer is D
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. LMWHs produce a more stable effect on coagulation; thus, fewer lab tests are needed: Correct LMWHs have a more predictable anticoagulant response compared to unfractionated heparin, resulting in a more stable effect on coagulation. Because of their predictable response, routine monitoring of coagulation parameters, such as activated partial thromboplastin time (aPTT), is typically not required with LMWH therapy, unlike with unfractionated heparin.
B. LMWHs may be given by the oral route: Incorrect. LMWHs are administered by the subcutaneous route.
C. LMWHs have a short duration of action: Incorrect. LMWHs have a longer duration of action compared to unfractionated heparin.
D. LMWHs possess greater anticoagulant activity: incorrect. LMWHs generally have less potent anticoagulant activity compared to unfractionated heparin, but their more predictable response and longer half-life make them advantageous in many clinical scenario
Correct Answer is B
Explanation
A. Oprelvekin (Neumega): Oprelvekin is a recombinant human interleukin-11 (IL-11) used to stimulate the production of platelets, not red blood cells. It is primarily indicated for patients with thrombocytopenia (low platelet count) due to chemotherapy.
B. Epoetin alfa (Procrit): Epoetin alfa is a synthetic form of erythropoietin, a hormone produced by the kidneys that stimulates the production of red blood cells in the bone marrow. It is commonly used to treat anemia associated with chronic kidney disease, chemotherapy, or HIV therapy. Therefore, it is administered to increase the number of circulating red blood cells.
C. Clopidogrel (Plavix): Clopidogrel is an antiplatelet medication that inhibits platelet aggregation, thereby reducing the risk of blood clots. It does not directly stimulate the production of red blood cells.
D. Filgrastim (Neupogen): Filgrastim is a recombinant human granulocyte colony-stimulating factor (G-CSF) that stimulates the production of white blood cells, particularly neutrophils, in the bone marrow. It is used to treat neutropenia (low white blood cell count) caused by chemotherapy, bone marrow transplantation, or certain diseases. It does not directly stimulate the production of red blood cells.
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