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. This client is at risk for other complications such as electrolyte imbalances or heart failure, but not specifically neurogenic shock.
B. This client is experiencing respiratory distress, which is a different type of shock (anaphylactic or septic shock might be considered, but not neurogenic).

C. Guillain-Barré syndrome is an autoimmune disorder that affects the nervous system, often leading to paralysis. It can cause a rapid loss of muscle function, which can result in neurogenic shock due to loss of sympathetic nervous system tone.
D. This client is at risk for hypovolemic shock due to fluid loss, not neurogenic shock.

A. It raises cardiac output and MAP. B. It causes vasoconstriction and increased MAP. C. There is no direct correlation to MAP. D. Lower blood volume lowers MAP.

Correct Answer is D

Explanation

A. Severe blood loss actually decreases blood volume, which leads to decreased cardiac output and ultimately lower MAP.
B. While it's true that the body initially responds to blood loss by vasoconstricting to maintain blood pressure, this compensatory mechanism can only last for so long. As blood loss continues, MAP will decrease.
C. There is no direct correlation to MAP. MAP is directly influenced by cardiac output and systemic vascular resistance (SVR). Blood volume is a major determinant of both.
D. A decrease in blood volume leads to decreased preload, which reduces cardiac output. This, in turn, lowers MAP.

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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 is providing care for a group of clients in the emergency department. Which of the following clients is at risk for developing neurogenic shock?

Correct Answer is C

Explanation

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Correct Answer is D

Explanation

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