A client in the emergency department is being prepared to receive tissue plasminogen activator (tPA). The nurse knows that which of the following is true regarding this medication?

The medication should be given with 5-6 hours of the onset of stroke systems

The medication is a primary treatment for haemorrhagic stroke.

The medication can be given to prevent clot formation in the context of head trauma

When given within a certain timeframe, the medication may dissolve an ischemic stroke

Answer and Explanation

The Correct Answer is D

A) "The medication should be given with 5-6 hours of the onset of stroke symptoms":
. tPA (tissue plasminogen activator) is typically given for an ischemic stroke, and it is most effective when administered within 3 to 4.5 hours of the onset of stroke symptoms. After this time frame, the risk of bleeding complications increases, and the benefits of the medication diminish significantly. Giving tPA after 6 hours is generally considered outside the therapeutic window for ischemic stroke, though some centers may extend the window based on specific criteria.

B) "The medication is a primary treatment for hemorrhagic stroke":
. tPA is contraindicated in hemorrhagic stroke because it works by dissolving clots, which could worsen bleeding in the brain. Hemorrhagic stroke occurs when there is bleeding in the brain, and administering tPA would exacerbate the bleeding, leading to more severe brain injury and complications. The primary treatment for hemorrhagic stroke is controlling bleeding, often through surgical interventions or managing blood pressure.

C) "The medication can be given to prevent clot formation in the context of head trauma":
. tPA is not used to prevent clot formation, particularly in the setting of head trauma. It is used to dissolve existing clots in cases of ischemic stroke. Administering tPA after head trauma or brain injury could lead to catastrophic complications, such as worsening bleeding, and should be avoided. The use of tPA is contraindicated in trauma-related situations unless the stroke is clearly ischemic and there are no signs of hemorrhage.

D) "When given within a certain timeframe, the medication may dissolve an ischemic stroke":
. tPA is the standard treatment for ischemic strokes (caused by a clot blocking blood flow to the brain). When administered within 3 to 4.5 hours of the onset of symptoms, tPA can dissolve the clot, improving blood flow to the affected area of the brain and potentially minimizing the damage caused by the stroke. Timely administration is critical for maximizing its benefits in reducing disability and improving outcomes.

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Correct Answer is B

Explanation

A) Apply an ice pack for pain:
While ice might help with pain and swelling in some cases, the client’s symptoms suggest a serious circulation problem, possibly compartment syndrome or vascular injury. These symptoms indicate the need for immediate intervention to restore blood flow, not just pain relief.

B) Loosen any constricting bandages or braces:
The client’s symptoms are highly suggestive of impaired circulation, which could be caused by compartment syndrome) or a vascular injury. Loosening any constricting bandages or braces is crucial to restoring circulation to the affected limb. Immediate action to relieve pressure is necessary to prevent permanent damage.

C) Document and continue to monitor:
Documenting and continuing to monitor without immediate action is inappropriate. The client’s symptoms represent a potential emergency, and delaying intervention could lead to irreversible damage to the limb. Immediate action is required to prevent complications like tissue necrosis or loss of limb function.

D) Elevate the extremity:
Elevating the extremity is not appropriate in this situation, as it may worsen circulation to the affected limb. Elevation could reduce venous return, further compromising blood flow to the area. Instead, immediate action to relieve pressure and improve circulation is the priority.

A. Antiretrovirals (such as Zidovudine, Entacavir) B. Stool softeners and laxatives (such as Docusate, Senna) C. Corticosteroids or immunosuppressants (such as Prednisone, Sulfasalazine) D. Sulfamethoxazole trimethoprim (SMX-TMP. Bactrim)

Correct Answer is C

Explanation

Inflammatory Bowel Disease (IBD) includes Crohn’s disease and ulcerative colitis, both of which involve chronic inflammation of the gastrointestinal tract. During an exacerbation, treatment focuses on reducing inflammation and controlling symptoms.

Corticosteroids (e.g., Prednisone): Used for short-term inflammation control during flare-ups.
Immunosuppressants (e.g., Sulfasalazine, Azathioprine, Methotrexate): Help maintain remission and reduce immune system overactivity.
Biologic agents (e.g., Infliximab, Adalimumab): Used for severe cases or when other treatments fail.

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