Which of the following is not a contraindication for the use of tissue plasminogen activator (PA) in the treatment of stroke?

Recent thoracic surgery within the past week

Uncontrolled hypertensive crisis

Age over 65 years

Head trauma with active cerebral hemorrhage

Answer and Explanation

The Correct Answer is C

A. Recent thoracic surgery within the past week:
Recent surgery, especially in the thoracic region, is a contraindication for the use of tissue plasminogen activator (tPA) in stroke treatment. tPA is a thrombolytic agent that dissolves clots, but it also increases the risk of bleeding, including in areas where surgery has recently occurred. Using tPA in this situation can potentially lead to life-threatening bleeding complications.

B. Uncontrolled hypertensive crisis:
Uncontrolled hypertension is a contraindication for tPA. High blood pressure can increase the risk of hemorrhagic transformation (bleeding into the brain) when using thrombolytic therapy like tPA. A hypertensive crisis (typically systolic BP > 185 mmHg or diastolic BP > 110 mmHg) must be managed and brought under control before administering tPA to minimize the risk of bleeding complications.

C. Age over 65 years:
While age over 65 years may increase the risk of complications from tPA, it is not an absolute contraindication for its use. Guidelines for tPA administration in stroke patients typically focus more on factors like time from symptom onset (usually within 4.5 hours), the presence of contraindications like recent surgery or uncontrolled hypertension, and the overall clinical condition. Age itself is not a reason to withhold tPA unless other risk factors are present.

D. Head trauma with active cerebral hemorrhage:
Head trauma with active cerebral hemorrhage is a definitive contraindication for tPA. Since tPA is a clot-busting drug, it can worsen bleeding in the brain, especially in cases where there is ongoing hemorrhage from trauma. This significantly increases the risk of severe neurological damage and even death, so tPA should not be administered in such situations.

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Free Nursing Study Resources

Correct Answer is ["7"]

Explanation

Given:

Desired dose: Amoxicillin 350 mg PO

Available concentration: Amoxicillin 250 mg/5 ml

To find:

Volume to administer (in ml)

Step 1: Set up the proportion

We can use the following proportion to solve the problem:

(Desired dose) / (Available concentration) = Volume to administer

Step 2: Substitute the values

Plugging in the given values, we get:

(350 mg) / (250 mg/5 ml) = Volume to administer

Step 3: Simplify

To simplify, we can invert the denominator and multiply:

(350 mg) x (5 ml / 250 mg) = Volume to administer

The "mg" units cancel out, leaving us with:

(350 x 5 ml) / 250 = Volume to administer

Step 4: Calculate

Performing the multiplication and division, we get:

1750 ml / 250 = Volume to administer

1 ml = Volume to administer

A. 5% Dextrose in water B. 10% Dextrose in water C. 0.9% Sodium Chloride D. 0.45% Sodium Chloride

Correct Answer is C

Explanation

A) "5% Dextrose in water (D5W)":
. D5W is an isotonic solution that, once metabolized by the body, becomes hypotonic because the glucose is rapidly utilized, leaving water. It is typically used to provide free water for hydration or for patients who need a small amount of calories or fluid, but it is not the best choice for this client. The client's low blood pressure and symptoms of dehydration (nausea, vomiting, dizziness, and weakness) suggest that normal saline (0.9% sodium chloride) is the more appropriate choice to help restore circulatory volume and improve blood pressure.

B) "10% Dextrose in water (D10W)":
. D10W is a hypertonic solution with a higher concentration of glucose, used in specific situations such as severe hypoglycemia or for patients requiring a high amount of glucose. It is not appropriate for this patient, whose primary issue seems to be volume depletion due to nausea and vomiting. The focus should be on replenishing circulatory volume and addressing the hypotension, which normal saline (0.9% sodium chloride) would do more effectively than D10W.

C) "0.9% Sodium Chloride":
. 0.9% Sodium Chloride (normal saline) is an isotonic solution and is the most appropriate choice for fluid resuscitation in a client with low blood pressure (hypotension) and signs of dehydration (nausea, vomiting, dizziness). This solution will help restore circulatory volume, correct hypovolemia, and improve blood pressure. It is commonly used for initial fluid resuscitation in clients who are hypotensive and experiencing fluid loss due to vomiting.

D) "0.45% Sodium Chloride (half-normal saline)":
. 0.45% Sodium Chloride is a hypotonic solution, which is more appropriate for treating patients who have conditions like hypernatremia or require gradual hydration. However, in this case, the patient is presenting with hypotension, dizziness, and weakness, which are signs of fluid depletion. A hypotonic solution would not be appropriate in this context, as it could potentially worsen the patient's hypotension or lead to further fluid shifts. The focus should be on using normal saline (0.9% sodium chloride) to help restore circulatory volume and improve the low blood pressure.

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Which of the following is not a contraindication for the use of tissue plasminogen activator (PA) in the treatment of stroke?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer amoxicillin 350 mg PO. Available is amoxicillin 250 mg/5 mL. How many mL should the nurse administer? (Round to the nearest whole number.)

Correct Answer is ["7"]

Explanation

Correct Answer is C

Explanation

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