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concept of nursing 1
Fibrinolytic Therapy for Acute Ischemic Stroke
| Question | Answer |
|---|---|
| A 64-year-old patient with a history of hypertension and cardiovascular disease is brought to the emergency department because the right side of the face was drooping. The patient is also having difficulty speaking. | -- |
| Which piece of historical data would indicate that this patient may be a candidate for rtPA administration? | The onset of symptoms was less than 3 hours before the medication can be administered. |
| he results of a CT scan performed on a patient who weighs 75 kg indicate an ischemic stroke. The patient consents to receiving rtPA. Which total dose of rtPA should this patient receive? | 67.5 mg |
| rtPA has been infusing for 30 minutes when the patient begins to complain of a severe headache and starts vomiting. Which actions are appropriate? | Stop the rtPA infusion, notify the practitioner, and prepare the patient for an emergency CT scan. |
| A 48-year-old patient has received rtPA for an ischemic stroke. The spouse expresses concern about the patient’s bleeding gums. Which response is the most appropriate? | “There is always some bleeding after rtPA administration, but your spouse will be monitored closely.” |
| The nurse has just initiated the rtPA infusion for a patient with an ischemic stroke. When should the nurse next assess the patient’s vital signs and neurologic status? | with in 15 min |
| During an infusion of rtPA for AIS, a patient vomits 150 ml of bright red blood. Which intervention is appropriate? | Discontinue the rtPA infusion. |
| A patient is admitted with signs and symptoms of an acute stroke, and an order for fibrinolytic therapy is possible. Which vascular access option is most appropriate for this patient? | Two large peripheral catheters |
| A 70-year-old patient fell asleep at the usual time of 10 PM, slept peacefully, and woke at 6 AM with numbness in the right arm. At 6:20 AM, the patient’s whole right side became numb, and speech became slurred at 6:45 AM. | -- |
| The patient arrived at the emergency department at 7 AM and had a head CT scan that showed no intracranial bleed. When determining this patient’s suitability for rtPA, what time should be used for symptom onset? | 10PM |
| A 78-year-old patient developed left-sided numbness 3½ hours ago. The patient has a recent history of deep vein thrombosis and is being treated with low-molecular-weight heparin. The patient is obese; has chronic kidney disease stage 3; | -- |
| takes losartan, which controls hypertension; and was treated last year for prostate cancer. Which factor in this patient’s history is a contraindication for rtPA? | Low-molecular-weight heparin |
| What tool should be used to monitor a patient’s neurologic status during and after rtPA administration? | NIHSS |
Created by:
Lightnning54
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