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. While this is a good safety measure for any client, it doesn't address the specific issue of homonymous hemianopsia.
B. This can be helpful for clients with motor difficulties but does not address the visual impairment.
C. Since the client has a right-sided stroke and homonymous hemianopsia, they will likely miss food on the left side of their tray. Reminding them to scan that area can help prevent them from missing food.
D. While this might seem logical, it doesn't address the underlying issue of the client's visual impairment.

A. The P-R interval measures 0.22 seconds. B. The T wave is in the inverted position. C. The QRS duration is 0.20 seconds. D. The P wave falls before the QRS complex.

Correct Answer is D

Explanation

A. The normal P-R interval ranges from 0.12 to 0.20 seconds. A P-R interval longer than 0.20 seconds is considered prolonged and may indicate a first-degree AV block.
B. The T wave represents ventricular repolarization. Normally, the T wave is upright in most leads. An inverted T wave can indicate various conditions, including ischemia, electrolyte imbalances, or other abnormalities
C. The normal QRS duration ranges from 0.06 to 0.10 seconds. A QRS duration greater than 0.10 seconds indicates a delay in ventricular conduction, which could be due to a bundle branch block or other conduction abnormalities.
D. In a normal sinus rhythm, the P wave should consistently appear before each QRS complex. This reflects proper atrial depolarization followed by ventricular depolarization. This pattern indicates that the heart's electrical impulses are originating from the sinus node and are being properly conducted through the AV node to the ventricles.

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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?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is D

Explanation

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