A client who has just experienced a pulmonary embolism is administered alteplase (Activase). Which of the following side effects associated with this medication would the nurse assess for?
Hypokalemia
Internal bleeding
pancytopenia
Hypertension
The Correct Answer is B
A. Hypokalemia is not a common side effect of alteplase; instead, it may result from other factors.
B. Internal bleeding is a significant risk associated with thrombolytics like alteplase, as they promote the breakdown of clots but can also affect hemostasis.
C. Pancytopenia is not directly associated with alteplase use; it may occur with other medications or conditions.
D. Hypertension is not a common side effect of alteplase; instead, blood pressure may fluctuate but is not typically increased as a direct result of the medication.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. PT/INR is more relevant for monitoring anticoagulant therapy like warfarin, not heparin.
B. This response is accurate; heparin prevents further clot formation but does not dissolve existing clots, which can take time for the body to reabsorb.
C. Heparin begins to exert its effects quickly, and therapeutic levels are not measured by PT/INR but by aPTT or anti-factor Xa levels.
D. Clots do not dissolve immediately after the first dose of heparin; the medication's role is to prevent clot extension.
Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"D"}
Explanation
aPTT (Activated Partial Thromboplastin Time) is the primary lab test used to monitor the effectiveness of unfractionated heparin therapy. Heparin works by activating antithrombin III, which inhibits thrombin and factor Xa, thus prolonging the aPTT. Monitoring aPTT helps ensure that the heparin dose is therapeutic and reduces the risk of bleeding.
PT-INR (Prothrombin Time - International Normalized Ratio) is used to monitor patients on warfarin therapy. Warfarin inhibits vitamin K-dependent clotting factors, which affects the prothrombin time (PT). The INR standardizes PT results, allowing for consistent monitoring of anticoagulation status. It is critical to maintain the INR within the therapeutic range to balance the risk of thrombosis against the risk of bleeding.
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