A prescriber orders treatment with streptokinase for a patient admitted to the emergency department with an evolving myocardial infarction. Which of the following represents an appropriate action by the nurse?
a. If hypotension develops during streptokinase infusion, the rate of infusion should be increased.
b. Because one third of patients receiving streptokinase develop fever, aspirin should be administered prophylactically.
c. If the patient develops urticaria and flushing, the nurse should prepare for administration of an antihistamine.
d. Intramuscular injections should not be given while the streptokinase is infusing; however, subcutaneous injections may be given.
ANS: C
Streptokinase is a foreign protein extracted from cultures of streptococci, and antibodies may form. Consequently, an allergic reaction may occur, with manifestations such as urticaria, itching, flushing, and headache.
If hypotension develops during streptokinase infusion, the rate of infusion should be decreased.
Temperature elevation occurs in about one third of patients receiving streptokinase and should be treated with acetaminophen rather than aspirin to avoid further risk of bleeding.
Both subcutaneous and intramuscular injections should be avoided because of the risk for bleeding from puncture sites.
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