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.

Answer and Explanation

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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Correct Answer is D

Explanation

The client opens his eyes in response to voice, which scores 3 on the eye-opening part of the GCS.

Since the client does not understand questions, this would likely score 1 for verbal response, indicating incomprehensible sounds.

The motor response of bringing an arm up to a trapezius squeeze is localizing pain, which would score 5.

Therefore, the nurse would document the client's GCS score as E3V1M5, which totals to 9 out of a possible 15 points.

A. To convert atrial fibrillation to sinus rhythm B. To dissolve clots in the bloodstream C. To slow the response of the ventricles to the fast atrial impulses D. To reduce the risk of stroke in clients who have atrial fibrillation

Correct Answer is D

Explanation

A. To convert atrial fibrillation to sinus rhythm is the function of anti-arrhythmic medications, not anticoagulants like dabigatran.
B. This is the role of thrombolytic medications, not anticoagulants.
C. This is the function of beta-blockers or calcium channel blockers.
D. Dabigatran is an anticoagulant primarily used to prevent stroke in patients with atrial fibrillation by preventing blood clot formation.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

A nurse is preparing to administer dabigatran to a client who has atrial fibrillation. The nurse should explain that the purpose of this medication is which of the following?

Correct Answer is D

Explanation

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