The emergency department nurse is preparing an infusion of IV alteplase for a client who suffered a cerebrovascular accident (CVA). Which of the following statements is accurate about the administration of alteplase?
The drug is not given to clients who are taking anticoagulant or antiplatelet therapy.
The drug is given in a bolus over the first 3 minutes followed by a continuous infusion.
The recommended time for drug administration is within 90 minutes after admission to the emergency department.
The maximum dosage of the drug, including the bolus, is 120 mg intravenously.
The Correct Answer is B
A. While there are strict inclusion and exclusion criteria for alteplase administration, this statement is overly broad. There are certain situations where anticoagulant or antiplatelet therapy can be managed to allow for alteplase use.
B. Alteplase is administered as a bolus over 1 minute, followed by an infusion over 60 minutes.
C. While time is critical in stroke treatment, the recommended window for alteplase administration is typically within 3-4.5 hours of symptom onset.
D. The maximum dose of alteplase is actually 0.9 mg/kg, up to a maximum of 90 mg.
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Related Questions
Correct Answer is C
Explanation
A. Sedatives would further depress the respiratory muscles, worsening the myasthenic crisis.
B. Instruct the client to perform pursed lip breathing can be helpful for managing dyspnea in other conditions. However, it's not the priority in a myasthenic crisis where respiratory muscles are rapidly weakening.
C. As respiratory muscles weaken in a myasthenic crisis, the patient is at risk for respiratory failure. Preparing for mechanical ventilation is crucial.
D. A vasoconstrictor is used to treat shock, not a myasthenic crisis.
Correct Answer is ["B","C","G","H"]
Explanation
A. Obtain a wound culture: While important, it is not the immediate priority compared to fluid resuscitation, antibiotic administration, and lactate level measurement.
B. Early administration of antibiotics is crucial in sepsis management to prevent further tissue damage and organ dysfunction.
C. Fluid resuscitation is essential to improve blood pressure and organ perfusion. Rapid administration of fluids is necessary to stabilize the patient.
D. Inserting a nasogastric (NG) tube might be necessary later if the patient develops gastrointestinal issues, but it's not an immediate priority.
E. While blood transfusion might be necessary if the patient becomes severely hypotensive, it's not the initial step. Fluid resuscitation is attempted first.
F. Urine culture can be helpful in identifying the source of infection but is not the immediate priority.
G. Lactate levels are a biomarker for tissue hypoxia and can help assess the severity of sepsis.
H. Blood cultures are essential to identify the causative organism for targeted antibiotic therapy.
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