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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Abnormally prominent U wave is a classic sign of hypokalemia. The U wave is normally small and often hidden by the T wave. When it becomes prominent, it's a strong indicator of low potassium levels.
B. Inverted P wave is more indicative of atrial abnormalities, such as atrial fibrillation.
C. Elevated ST segment is often associated with myocardial ischemia or injury.
D. Wide QRS is more characteristic of conduction disturbances like bundle branch blocks.
Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A,B"},"C":{"answers":"A,B,C"},"D":{"answers":"B"},"E":{"answers":"A,B"}}
Explanation
Cognitive Function
- Cognitive function in Parkinson's disease can be relatively preserved early on, though some patients may develop cognitive impairment or dementia in later stages.
- Cognitive function can be significantly affected depending on the location and extent of brain damage. Sudden changes in cognition, such as confusion or difficulty forming words, are common in the acute phase following a stroke.
- Cognitive impairment is possible and can vary widely among patients. It is usually more subtle and may include difficulties with concentration and memory rather than dramatic changes.
Speech
- Speech abnormalities are common, such as reduced volume (hypophonia), monotone voice, and difficulty articulating words (dysarthria).
- Speech difficulties, including aphasia or dysarthria, are common, especially if the stroke affects the language centers of the brain.
- Speech problems can include slurred speech (dysarthria) and difficulty with articulation due to muscle weakness or coordination issues.
Mobility Status
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Characterized by bradykinesia (slowness of movement), rigidity, and tremors. Mobility issues are common, with patients often using assistive devices as the disease progresses.
- Mobility issues vary widely based on the affected brain areas. Weakness or paralysis on one side of the body (hemiparesis) and difficulty with gait and balance are common.
- Mobility issues can include weakness, spasticity, and coordination problems. Gait disturbances are common, and assistive devices may be used as the disease progresses.
Blood Pressure
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Blood pressure can vary but is not directly influenced by Parkinson's disease.
- High blood pressure is often a risk factor for stroke and can be present in both the acute phase and later stages.
- Blood pressure abnormalities are not a primary feature of MS, although secondary complications can affect it.
Facial Symmetry
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Parkinson's Disease is characterized by a reduced range of facial expressions (masked face) due to bradykinesia and rigidity, but typically no acute facial droop.
- Facial droop on one side is a common symptom, especially if the stroke affects the facial nerve area or motor control areas.
- Facial weakness or asymmetry can occur, but is less common compared to stroke.
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