Nokea
A patient is receiving thrombolytic therapy, and the nurse monitors the patient for adverse effects. What is the most common undesirable effect of thrombolytic therapy?
- A. Dysrhythmias
- B. Nausea and vomiting
- C. Anaphylactic reactions
- D. Internal and superficial bleeding
Correct Answer: D
Rationale: Bleeding, both internal and superficial, as well as intracranial, is the most common undesirable effect of thrombolytic therapy. The other options list possible adverse effects of thrombolytic drugs, but they are not the most common effects.
You may also like to solve these questions
A patient is receiving heparin therapy as part of the treatment for a pulmonary embolism. The nurse monitors the results of which laboratory test to check the drug's effectiveness?
- A. Bleeding times
- B. Activated partial thromboplastin time (aPTT)
- C. Prothrombin time/international normalized ratio (PT/INR)
- D. Vitamin K levels
Correct Answer: B
Rationale: Ongoing aPTT values are used to monitor heparin therapy. PT/INR is used to monitor warfarin therapy. The other two options are not used to monitor anticoagulant therapy.
A patient is being discharged on anticoagulant therapy. The nurse will include in the patient-education conversation that it is important to avoid herbal products that contain which substance?
- A. Soy
- B. Valerian
- C. Saw palmetto
- D. St. John's wort
Correct Answer: D
Rationale: Capsicum pepper, dong quai, feverfew, garlic, ginger, ginkgo, and St. John's wort are some herbal products that have potential interactions with anticoagulants, especially with warfarin.
A patient has received an overdose of intravenous heparin, and is showing signs of excessive bleeding. Which substance is the antidote for heparin overdose?
- A. Vitamin E
- B. Vitamin K
- C. Protamine sulfate
- D. Potassium chloride
Correct Answer: C
Rationale: Protamine sulfate is a specific heparin antidote and forms a complex with heparin, completely reversing its anticoagulant properties. Vitamin K is the antidote for warfarin (Coumadin) overdose. The other options are incorrect.
An elderly patient has had hip surgery and will be receiving heparin, 4000 units subcutaneously every 12 hours. The heparin is available in vials of 5000 units/mL. Calculate how much heparin the nurse will administer for this dose.
Correct Answer: 0.8 mL
Rationale: 5000 units : 1 mL :: 4000 units : x mL; (5000 * x) = (1 * 4000); 5000x = 4000; x = 4000/5000 = 0.8 mL.
The nurse is reviewing new medication orders for a patient who has an epidural catheter for administration of pain medications. One of the orders is for enoxaparin, a low-molecular-weight heparin (LMWH). What is the nurse's priority action?
- A. Give the LMWH as ordered.
- B. Double-check the LMWH order with another nurse, and then administer as ordered.
- C. Stop the epidural pain medication, and then administer the LMWH.
- D. Contact the prescriber because the LMWH cannot be given if the patient has an epidural catheter.
Correct Answer: D
Rationale: LMWHs are contraindicated in patients with an indwelling epidural catheter; they can be given 2 hours after the epidural is removed. This is very important to remember, because giving an LMWH with an epidural has been associated with epidural hematoma.