A client who had a thrombotic stroke finished receiving intravenous rt-PA therapy at 10:00 AM on Sunday. Sunday afternoon the physician writes an order to start Coumadin and Plavix that evening. The most appropriate action by the nurse would be to
a. call the physician and clarify when the medications should be given.
b. consult with the pharmacist about giving both medications together.
c. give the Coumadin at 5:00 PM because that is the standard administration time.
d. provide appropriate education and administer the medications as ordered.
A
Bleeding, which can be severe or even fatal, is a possible complication of rt-TPA. Fatal hemorrhages generally occur within the first 24 hours after rt-TPA. Therefore anticoagulants and antiplatelet medications are not recommended until 24 hours after administration of rt-TPA.
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