The emergency department nurse is preparing an infusion of IV alteplase for a client who suffered a cerebrovascular accident (CVA). Which of the following statements is accurate about the administration of alteplase?

The drug is not given to clients who are taking anticoagulant or antiplatelet therapy.

The drug is given in a bolus over the first 3 minutes followed by a continuous infusion.

The recommended time for drug administration is within 90 minutes after admission to the emergency department.

The maximum dosage of the drug, including the bolus, is 120 mg intravenously.

Answer and Explanation

The Correct Answer is B

A.   While there are strict inclusion and exclusion criteria for alteplase administration, this statement is overly broad. There are certain situations where anticoagulant or antiplatelet therapy can be managed to allow for alteplase use.
B.   Alteplase is administered as a bolus over 1 minute, followed by an infusion over 60 minutes.
C.   While time is critical in stroke treatment, the recommended window for alteplase administration is typically within 3-4.5 hours of symptom onset.
D.   The maximum dose of alteplase is actually 0.9 mg/kg, up to a maximum of 90 mg.

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Correct Answer is C

Explanation

A. Sedatives would further depress the respiratory muscles, worsening the myasthenic crisis.
B. Instruct the client to perform pursed lip breathing can be helpful for managing dyspnea in other conditions. However, it's not the priority in a myasthenic crisis where respiratory muscles are rapidly weakening.
C. As respiratory muscles weaken in a myasthenic crisis, the patient is at risk for respiratory failure. Preparing for mechanical ventilation is crucial.
D. A vasoconstrictor is used to treat shock, not a myasthenic crisis.

A. Drooling B. Blood pressure at 1800 C. Breath sounds at 1000 D. Hoarse voice E. Temperature at 1800

Correct Answer is ["A","D","E"]

Explanation

A. Drooling
Drooling can be concerning due to impaired swallowing and risk of aspiration.
D. Hoarse voice
Hoarseness after swallowing can indicate aspiration, which is a serious complication for stroke patients due to difficulty swallowing.
E. Temperature at 1800
A temperature of 39.6°C (103.3°F) is significantly elevated and suggests a potential infection, which is a serious complication after a stroke

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The emergency department nurse is preparing an infusion of IV alteplase for a client who suffered a cerebrovascular accident (CVA). Which of the following statements is accurate about the administration of alteplase?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse suspects a client who has myasthenia gravis is experiencing a myasthenic crisis. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

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Correct Answer is ["A","D","E"]

Explanation

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