A nurse is caring for a client who has pulmonary embolism and is receiving alteplase via continuous IV infusion.The nurse should monitor for which adverse effects of this medication? (Select all that apply.)

Hypotension

Bleeding

Dysrhythmias

Nausea

Fever.

Answer and Explanation

Correct Answer : B

Alteplase is a fibrinolytic agent that dissolves blood clots and restores blood flow. However, it also increases the risk of bleeding from any site, such as the nose, gums, injection sites, or internal organs. Therefore, the nurse should monitor the client for signs of bleeding, such as bruising, hematuria, hematemesis, melena, or decreased hemoglobin and hematocrit levels.

Choice A is wrong because hypotension is not a common adverse effect of alteplase. Hypotension may occur due to blood loss from bleeding or other causes, such as dehydration, sepsis, or cardiac dysfunction.

Choice C is wrong because dysrhythmias are not a common adverse effect of alteplase. Dysrhythmias may occur due to pulmonary embolism itself, which can cause hypoxia, acidosis, and increased pulmonary artery pressure.

Choice D is wrong because nausea is not a common adverse effect of alteplase. Nausea may occur due to other factors, such as anxiety, pain, or medications.

Choice E is wrong because fever is not a common adverse effect of alteplase. Fever may occur due to infection, inflammation, or other causes.

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Correct Answer is C

Explanation

Activated partial thromboplastin time (aPTT).

Dabigatran (Pradaxa) is a direct oral anticoagulant (DOAC) that inhibits thrombin, a key enzyme in the coagulation cascade.

Dabigatran prolongs the aPTT, which is a measure of the intrinsic and common pathways of coagulation.The aPTT can be used to monitor the anticoagulant effect of dabigatran, although routine monitoring is not required.

Choice A) Prothrombin time (PT) is wrong because PT measures the extrinsic and common pathways of coagulation, which are not affected by dabigatran.

PT is used to monitor warfarin therapy, not dabigatran.

Choice B) International normalized ratio (INR) is wrong because INR is a standardized version of PT that is used to monitor warfarin therapy, not dabigatran.

INR is not affected by dabigatran.

Choice D) Platelet count is wrong because platelet count is a measure of the number of platelets in the blood, which are involved in primary hemostasis.

Platelet count is not affected by dabigatran, which acts on secondary hemostasis.

Normal ranges for these tests are:

• aPTT: 25 to 35 seconds

• PT: 11 to 13.5 seconds

• INR: 0.8 to 1.2

• Platelet count: 150,000 to 450,000 per microliter of blood

A. “I will take aspirin if I get a headache.” B. “I will avoid activities that may cause injury.” C. “I will take my medication with food.” D. “I will stop taking my medication if I feel better.”.

Correct Answer is B

Explanation

This statement indicates that the patient understands that rivaroxaban (Xarelto) is an anticoagulant that can increase the risk of bleeding and bruising.The patient should avoid activities that may cause injury, such as contact sports, sharp objects, or falls.

Choice A is wrong because aspirin is also an antiplatelet drug that can further increase the risk of bleeding when taken with rivaroxaban.The patient should not take aspirin or any other nonsteroidal anti-inflammatory drugs (NSAIDs) without consulting the prescriber.

Choice C is wrong because rivaroxaban can be taken with or without food.The patient does not need to take the medication with food to prevent stomach upset or absorption problems.

Choice D is wrong because rivaroxaban should be taken as prescribed and not stopped abruptly without consulting the prescriber.Stopping the medication can increase the risk of blood clots and stroke.The patient should not stop taking the medication even if they feel better or have no symptoms.

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A nurse is caring for a client who has pulmonary embolism and is receiving alteplase via continuous IV infusion.The nurse should monitor for which adverse effects of this medication? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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