While reviewing newly prescribed orders, the nurse begins to prepare a patient to receive plasminogen activator alteplase (tPA). What should the nurse realize about this patient's health problem?
Select all that apply.
1. The patient had an ischemic stroke.
2. The patient had a hemorrhagic stroke.
3. The patient has uncontrollable seizure activity.
4. The patient had a stroke less than 3 hours ago.
5. The patient's systolic blood pressure is greater than 200 mmHg.
Correct Answer: 1, 4
Fibrinolytic therapy, using a tissue plasminogen activator such as recombinant tissue-type plasminogen activator alteplase (tPA), is used to treat ischemic stroke. The drug converts plasminogen to plasmin, resulting in fibrinolysis of the clot. To be effective, it must be given IV within 3 hours of the onset of manifestations, after confirming (with a CT scan) that the patient has not had a hemorrhagic stroke. This medication is not used to control seizure activity. If the blood pressure is sustained at systolic levels >185 mmHg, the patient cannot be treated with IV tPA.
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Which of the following best describes why there are more long-term consequences (such as death) to a driver injured in a truck accident in a rural area than a driver injured in a truck accident in an urban area? (Select all that apply.)
a. Rural drivers are more likely to speed over long distances than urban drivers. b. Rural drivers are not as skilled with vehicles as urban drivers, so they are more severely injured in a crash. c. The urban driver is taken immediately for care, whereas the rural driver might be injured on an isolated field and not found by anyone for hours. d. Urban drivers are more likely to use their seat belts than rural drivers. e. Urban drivers are probably rushed to an emergency department, whereas the rural driver lives far away from emergency services, often over bad roads and possibly through severe weather. f. Urban drivers trade their vehicles in rather frequently, whereas rural drivers keep their vehicles for as long as they can make them run, so the vehicles are much less roadworthy.
Sustained release medications must be
A. chewed. B. crushed. C. swallowed whole. D. broken in half.
Through a medication error, a client is experiencing an overdose of atropine sulfate. The nurse should:
a. place a padded tongue blade between the client's teeth. b. prepare to administer intravenous physostigmine. c. obtain blood specimens for electrolyte levels. d. prepare to administer intramuscular hyoscyamine sulfate.
Nitrites
What will be an ideal response?