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

Answer and Explanation

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.

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Correct Answer is ["A","B","C","D","E"]

Explanation

A. Alteplase (Activase): Alteplase is a thrombolytic agent used to dissolve blood clots. Concurrent use with clopidogrel, an antiplatelet medication, can increase the risk of bleeding due to additive effects on clotting. Therefore, it's important to consult the doctor before using these medications together.

B. Diltiazem: Diltiazem is a calcium channel blocker used to treat hypertension and certain heart rhythm disorders. Diltiazem will decrease the level or effect of clopidogrel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Therefore, it's advisable to consult the doctor before using these medications together.

C. Ibuprofen: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) used to relieve pain and inflammation. Like other NSAIDs, it can increase the risk of bleeding when taken with clopidogrel. Therefore, it's important to consult the doctor before using these medications together.

D. Aspirin: Aspirin is another antiplatelet medication commonly used to prevent heart attacks and strokes. Combining clopidogrel with aspirin can increase the risk of bleeding without significantly improving outcomes in most cases. However, in some situations, such as after certain cardiac procedures, dual antiplatelet therapy (clopidogrel plus aspirin) may be prescribed under close medical supervision. Therefore, it's crucial to consult the doctor before using these medications together.

E. Coumadin (warfarin): Coumadin is an anticoagulant medication used to prevent blood clots. Concurrent use with clopidogrel can increase the risk of bleeding. Therefore, it's essential to consult the doctor before using these medications together.

A. Increase the risk for bleeding B. Cause severe headache C. Decrease the effects of the warfarin (Coumadin) D. Cause severe hypotension

Correct Answer is A

Explanation

A. Increase the risk for bleeding: Herbal supplements like green tea, ginkgo, feverfew, garlic, and ginger can potentiate the effects of warfarin by enhancing its anticoagulant properties. This increases the risk of bleeding, as warfarin itself is a blood thinner designed to prevent clot formation. These herbs can further inhibit platelet aggregation or enhance anticoagulation, leading to a higher risk of bleeding complications.

B. Cause severe headache: While some herbal supplements can cause headaches as a side effect, this is not the primary concern when combined with warfarin. The interaction between these herbs and warfarin does not commonly result in severe headaches. The primary issue is the increased risk of bleeding.

C. Decrease the effects of the warfarin (Coumadin): These particular herbal supplements do not generally decrease the effects of warfarin. In fact, they are more likely to increase its anticoagulant effects. Some other substances might interfere with warfarin's efficacy, but the herbs listed are known to enhance its bleeding risk.

D. Cause severe hypotension: Severe hypotension is not a common result of combining these herbal supplements with warfarin. The primary interaction is related to the blood-thinning effects, not to blood pressure regulation. Herbal supplements that might affect blood pressure are not typically those that interact significantly with warfarin in this manner.

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A patient is receiving alteplase (Activase), a thrombolytic drug. The nurse monitors the patient for which of the following possible adverse effects?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["A","B","C","D","E"]

Explanation

A client taking warfarin (Coumadin) should be instructed to avoid herbal supplements such as green tea, ginkgo, feverfew, garlic, and ginger because these could:

Correct Answer is A

Explanation

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