Thrombolytic agents
Thrombolytic agents ( 5 Questions)
A nurse is preparing to administer alteplase, a second-generation thrombolytic agent, to a client with an acute ischemic stroke. Which of the following actions should the nurse take before administering the medication?
Alteplase can cause bleeding and hypotension, so the nurse should monitor the client’s vital signs closely and report any abnormal findings to the provider.
Alteplase can increase the risk of hemorrhage, so the nurse should check the client’s platelet count, hemoglobin, hematocrit, prothrombin time (PT), international normalized ratio (INR), and activated partial thromboplastin time (aPTT) before and during therapy. The normal ranges for these tests are as follows:
➤ Platelet count: 150,000–400,000/mm3
➤ Hemoglobin: 13.5–17.5 g/dL for males; 12.0–15.5 g/dL for females
➤ Hematocrit: 38.8–50.0% for males; 34.9–44.5% for females
➤ PT: 11–13.5 seconds
➤ INR: 0.8–1.1
➤ aPTT: 25–35 seconds
Alteplase can improve the neurological outcome of ischemic stroke by dissolving the clot and restoring blood flow to the brain. However, it can also cause intracranial hemorrhage, which can worsen the neurological deficit. Therefore, the nurse should use a scale such as the National Institutes of Health Stroke Scale (NIHSS) or the Glasgow Coma Scale (GCS) to evaluate the client’s level of consciousness, motor function, sensory function, speech, vision, and other neurological functions before and after administering alteplase.
The nurse should take all of the following actions before administering alteplase, a second-generation thrombolytic agent, to a client with an acute ischemic stroke:
• Check the client’s blood pressure and pulse. Alteplase can cause bleeding and hypotension, so the nurse should monitor the client’s vital signs closely and report any abnormal findings to the provider.
• Obtain a baseline complete blood count (CBC) and coagulation studies. Alteplase can increase the risk of hemorrhage, so the nurse should check the client’s platelet count, hemoglobin, hematocrit, prothrombin time (PT), international normalized ratio (INR), and activated partial thromboplastin time (aPTT) before and during therapy. The normal ranges for these tests are as follows:
➤ Platelet count: 150,000–400,000/mm3
➤ Hemoglobin: 13.5–17.5 g/dL for males; 12.0–15.5 g/dL for females
➤ Hematocrit: 38.8–50.0% for males; 34.9–44.5% for females
➤ PT: 11–13.5 seconds
➤ INR: 0.8–1.1
➤ aPTT: 25–35 seconds
• Assess the client’s neurological status using a standardized scale. Alteplase can improve the neurological outcome of ischemic stroke by dissolving the clot and restoring blood flow to the brain. However, it can also cause intracranial hemorrhage, which can worsen the neurological deficit. Therefore, the nurse should use a scale such as the National Institutes of Health Stroke Scale (NIHSS) or the Glasgow Coma Scale (GCS) to evaluate the client’s level of consciousness, motor function, sensory function, speech, vision, and other neurological functions before and after administering alteplase.
The nurse should take all of the following actions before administering alteplase, a second-generation thrombolytic agent, to a client with an acute ischemic stroke:
• Check the client’s blood pressure and pulse. Alteplase can cause bleeding and hypotension, so the nurse should monitor the client’s vital signs closely and report any abnormal findings to the provider.
• Obtain a baseline complete blood count (CBC) and coagulation studies. Alteplase can increase the risk of hemorrhage, so the nurse should check the client’s platelet count, hemoglobin, hematocrit, prothrombin time (PT), international normalized ratio (INR), and activated partial thromboplastin time (aPTT) before and during therapy. The normal ranges for these tests are as follows:
➤ Platelet count: 150,000–400,000/mm3
➤ Hemoglobin: 13.5–17.5 g/dL for males; 12.0–15.5 g/dL for females
➤ Hematocrit: 38.8–50.0% for males; 34.9–44.5% for females
➤ PT: 11–13.5 seconds
➤ INR: 0.8–1.1
➤ aPTT: 25–35 seconds
• Assess the client’s neurological status using a standardized scale. Alteplase can improve the neurological outcome of ischemic stroke by dissolving the clot and restoring blood flow to the brain. However, it can also cause intracranial hemorrhage, which can worsen the neurological deficit. Therefore, the nurse should use a scale such as the National Institutes of Health Stroke Scale (NIHSS) or the Glasgow Coma Scale (GCS) to evaluate the client’s level of consciousness, motor function, sensory function, speech, vision, and other neurological functions before and after administering alteplase.