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 A

Explanation

A. Elevating the head of the bed is a cornerstone of managing increased intracranial pressure (ICP). Elevating the head of the bed to 30 degrees promotes venous drainage from the brain, helping to reduce ICP.
B. A brightly lit environment can stimulate the patient and increase ICP. A calm, dark environment is preferred.
C. Fluid restriction, not encouragement, is often necessary to manage ICP. Excessive fluid can increase intracranial volume.
D. Controlled coughing and deep breathing are important for lung expansion but coughing and straining can increase ICP. Gentle breathing exercises are preferred.

Correct Answer is ["5.3"]

Explanation

1 pound = 0.453592 kilograms

28 pounds = 28 * 0.453592 = 12.7 kilograms

Dose = weight in kg * prescribed dose Dose = 12.7 kg * 10 mg/kg = 127 mg

The medication is availableas 120 mg/5 mL. To find the volume for 127 mg:

Volume = (desired dose / concentration) * volume Volume = (127 mg / 120 mg) * 5 mL

Volume ≈ 5.29 mL

Therefore, the nurse should administer approximately 5.3 mL of acetaminophen.

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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

A nurse is caring for a client who has increased intracranial pressure. Which of the following interventions should the nurse take?

Correct Answer is A

Explanation

A nurse is preparing to administer acetaminophen 10 mg/kg/dose to a child who weighs 28 lb. The amount available is acetaminophen 120 mg/5 mL. How many ml should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["5.3"]

Explanation

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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?

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