The nurse is administering a thrombolytic agent to a patient having an acute myocardial infarction. Which patient data indicates that the nurse should stop the drug infusion?.
A brief episode of ventricular tachycardia.
Bleeding from the gums.
Decreased level of consciousness.
An increase in blood pressure.
The Correct Answer is B
Choice A rationale:
A brief episode of ventricular tachycardia, or a rapid heart rate, can occur in patients receiving thrombolytic therapy. However, it is not typically a reason to stop the drug infusion.
Choice B rationale:
Bleeding from the gums can be a sign of excessive bleeding, which is a major risk of thrombolytic therapy. This would be a reason to stop the drug infusion.
Choice C rationale:
A decreased level of consciousness can have many causes and is not specifically associated with thrombolytic therapy.
Choice D rationale:
An increase in blood pressure is not typically a reason to stop thrombolytic therapy.
So, the correct answer is B, after analyzing all choices.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
While bilateral crackles at the lung bases indicate fluid accumulation, a common symptom of dilated cardiomyopathy, it’s not as immediately life-threatening as some other conditions.
Choice B rationale:
Acute aortic regurgitation can lead to a rapid and severe drop in blood pressure, which is a medical emergency. Therefore, this patient should be assessed first.
Choice C rationale:
While a murmur and splinter hemorrhages are symptoms of infective endocarditis, they are not as immediately life-threatening as acute aortic regurgitation.
Choice D rationale:
Sharp chest pain with a deep breath could be a symptom of rheumatic fever, but it’s not as immediately life-threatening as acute aortic regurgitation.
So, the correct answer is Choice B, after analyzing all choices.
Correct Answer is B
Explanation
Choice A rationale:
Teaching the patient to take deep, slow breaths might not be effective in controlling the pain due to acute pericarditis.
Choice B rationale:
Placing the patient in Fowler’s position, leaning forward on the table, can help relieve the pain associated with acute pericarditis.
Choice C rationale:
Forcing fluids to 3000 mL/day to decrease inflammation is not a recommended action for managing pain due to acute pericarditis.
Choice D rationale:
Providing a fresh ice bag every hour for the patient to place on the chest is not a recommended action for managing pain due to acute pericarditis.
So, the correct answer is B, after analyzing all choices.
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