A patient is receiving alteplase (Activase), a thrombolytic drug. The nurse monitors the patient for which of the following possible adverse effects?

Temperature of 100.8 Degrees Fahrenheit (38.2 Degrees Celsius)

Skin rash with urticaria

Wheezing with labored breathing

Bruising and epistaxis

Answer and Explanation

The Correct Answer is D

A. Temperature of 100.8 Degrees Fahrenheit (38.2 Degrees Celsius): Fever can indicate a potential adverse reaction to the medication or may be a sign of infection, which could complicate the patient's condition. While a fever can be a sign of an infection, it's not a typical adverse effect for alteplase

B. Skin rash with urticaria: Skin rash and urticaria (hives) can indicate an allergic reaction to alteplase. Allergic reactions can range from mild to severe and may necessitate discontinuation of the medication and administration of appropriate treatment, such as antihistamines or corticosteroids, depending on the severity of the reaction but it's less common than bleeding.

C. Wheezing with labored breathing: Wheezing and labored breathing can indicate a severe allergic reaction or anaphylaxis to alteplase but again, bleeding is a more prominent concern.

D. Bruising and epistaxis: Alteplase increases the risk of bleeding due to its thrombolytic activity. Bruising and epistaxis (nosebleeds) are common manifestations of bleeding associated with alteplase therapy. Monitoring for these signs helps detect potential bleeding complications early, allowing for prompt intervention to minimize further bleeding and manage the patient's condition appropriately.

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Correct Answer is D

Explanation

A. Clotting at the incision site. Enoxaparin (Lovenox) is an anticoagulant medication used to prevent blood clots, particularly deep vein thrombosis (DVT) and pulmonary embolism (PE), which are common complications following orthopedic surgeries like knee replacement. Monitoring for clotting at the incision site is essential to ensure that the medication is effectively preventing excessive clot formation while also ensuring that the patient does not experience excessive bleeding.

B. Increased pain. While increased pain could be a concern postoperatively, particularly after a surgical procedure like knee replacement, it is not a specific monitoring parameter for enoxaparin administration. Pain management is typically addressed separately, and increased pain may indicate issues such as inadequate analgesia, surgical complications, or other factors unrelated to enoxaparin therapy.

C. Gingival hyperplasia. Gingival hyperplasia refers to an overgrowth of gum tissue and is not directly associated with enoxaparin therapy. This side effect is more commonly associated with certain medications such as phenytoin and cyclosporine rather than anticoagulants like enoxaparin. Monitoring for gingival hyperplasia would not be relevant in this context.

D. Signs and symptoms of bruising and bleeding. This is the correct answer. Enoxaparin is an anticoagulant medication, which increases the risk of bleeding. Therefore, monitoring for signs and symptoms of bruising and bleeding is crucial to detect any potential complications such as hemorrhage or hematoma formation. This includes assessing for unusual bruising, bleeding from the gums, nosebleeds, hematuria, melena, or any other signs of internal or external bleeding. Prompt recognition and management of bleeding complications are essential to ensure patient safety during enoxaparin therapy, especially following orthopedic surgery.

A. Increase the risk for bleeding B. Cause severe headache C. Decrease the effects of the warfarin (Coumadin) D. Cause severe hypotension

Correct Answer is A

Explanation

A. Increase the risk for bleeding: Herbal supplements like green tea, ginkgo, feverfew, garlic, and ginger can potentiate the effects of warfarin by enhancing its anticoagulant properties. This increases the risk of bleeding, as warfarin itself is a blood thinner designed to prevent clot formation. These herbs can further inhibit platelet aggregation or enhance anticoagulation, leading to a higher risk of bleeding complications.

B. Cause severe headache: While some herbal supplements can cause headaches as a side effect, this is not the primary concern when combined with warfarin. The interaction between these herbs and warfarin does not commonly result in severe headaches. The primary issue is the increased risk of bleeding.

C. Decrease the effects of the warfarin (Coumadin): These particular herbal supplements do not generally decrease the effects of warfarin. In fact, they are more likely to increase its anticoagulant effects. Some other substances might interfere with warfarin's efficacy, but the herbs listed are known to enhance its bleeding risk.

D. Cause severe hypotension: Severe hypotension is not a common result of combining these herbal supplements with warfarin. The primary interaction is related to the blood-thinning effects, not to blood pressure regulation. Herbal supplements that might affect blood pressure are not typically those that interact significantly with warfarin in this manner.

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A patient is receiving alteplase (Activase), a thrombolytic drug. The nurse monitors the patient for which of the following possible adverse effects?

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Naxlex Comprehensive Predictor Exams

The patient is receiving enoxaparin (Lovenox) subcutaneously every 12 hours following knee replacement surgery. The patient is monitored for.

Correct Answer is D

Explanation

A client taking warfarin (Coumadin) should be instructed to avoid herbal supplements such as green tea, ginkgo, feverfew, garlic, and ginger because these could:

Correct Answer is A

Explanation

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