LAB - 7.4 - Thrombolytics and Antiplatelets

Question 1

The general action of thrombolytic agents is the

Answer 1

selective degradation of formed fibrin clots with minimal effect on clot formation.

Question 2

This is administered for disorders in which an intravascular clot has already formed such as in acute myocardial infarction, pulmonary embolism, acute ischemic cerebrovascular accident (CVA), and deep vein thrombosis (DVT )

Answer 2

Thrombolytics

Question 3

Thrombolytics are administered for disorders in which an intravascular clot has already formed such as in

Answer 3

acute myocardial infarction, pulmonary embolism, acute ischemic cerebrovascular accident (CVA), and deep vein thrombosis (DVT )

Question 4

Thrombolytics are used early in the course of myocardial infarction within ___ hours of the onset of the infarct to restore blood flow

Answer 4

4 to 6

Question 5

Thrombolytics time limitation is not related to drug activity, because thrombolytic agents can break down clots older than ___ hours.

Answer 5

6

Question 6

Rather, tissue that has been anoxic for more than 6 hours is not likely to benefit from thrombolytic therapy, making the risks to the client greater than the advantages.

Answer 6

NA

Question 7

The goal of thrombolytic therapy is to quickly restore blood flow to the tissue served by the blocked vessel.

Answer 7

NA

Question 8

Contraindications for thrombolytics

Answer 8

active internal bleeding, history of CVA, intracranial problems, trauma within the previous 2 months

Question 9

Examples of Thrombolytics

Answer 9

Alteplase

Streptokinase

Fondaparinux (Arixtra)

Question 10

If this thrombolytic is administered within 3 hours of onset of ischemic stroke, it significantly improves clinical outcomes especially the patient’s ability to perform activities of daily living

Answer 10

Alteplase

Question 11

Adverse effects Alteplase

Answer 11

Bleeding complications including GI and cerebral hemorrhages

Question 12

This thrombolytic’s therapy is instituted within 4 hours of myocardial infarction and is infused for one hour

Answer 12

Streptokinase

Question 13

Streptokinase therapy is instituted within ___ hours of myocardial infarction and is infused for ___ hour

Answer 13

4

1

Question 14

For Streptokinase, Thromboplastin time is monitored and maintained at ___ fold the control value

Answer 14

2-5

Question 15

this is a specific blocker of factor Xa for the prevention of venous thromboembolic events in patients undergoing surgery for hip fracture, hip or knee replacement.

Answer 15

Fondaparinux (Arixtra)

Question 16

What does Fondaparinux (Arixtra) block?

Answer 16

factor Xa

Question 17

Antidote for Fondaparinux (Arixtra)

Answer 17

Aminocaprioc acid (Amicar)

Question 18

these drugs Inhibit the aggregation of platelets in the clotting process, thereby prolonging bleeding time

Answer 18

Antiplatelet Medications

Question 19

these drugs are used in the prophylaxis of long-term complications following MI and CVA

Answer 19

Antiplatelet Medications

Question 20

Contraindications for Antiplatelet Medications

Answer 20

in bleeding disorders and known sensitivity

Question 21

Side effects for Antiplatelet Medications

Answer 21

GI bleeding, bruising, hematuria, tarry stools

Question 22

is the clot that adheres to the vessel wall

Answer 22

THROMBUS

Question 23

is the CLOT that floats in the blood

Answer 23

EMBOLUS

Question 24

is the formation of unwanted clot within the blood vessel, producing life threatening conditions such as:

Answer 24

THROMBOSIS

Question 25

Conditions where thrombosis can occur:

Answer 25

Acute myocardial infarction Acute ischemic stroke Deep vein thrombosis Pulmonary embolism

Question 26

Examples of Antiplatelet Drugs

Answer 26

clopidogrel (Plavix) cilostazol (Pletaal) acetlysalicylic acid (Aspirin)

Question 27

this antiplatelet is used in patients who are at risk for ischemic events and those with a history of MI

Answer 27

clopidogrel (Plavix)

Question 28

this antiplatelet is indicated for the reduction of symptoms of intermittent claudication, allowing increased walking distance

Answer 28

cilostazol (Pletaal)

Question 29

this antiplatelet is effective in decreasing incidence of Transient Ischemic Attack (TIAs)

Answer 29

acetlysalicylic acid (Aspirin)

Question 30

Adverse Effects of Antiplatelets

Answer 30

Most common adverse effect is bleeding, which often occurs as increased bruising and bleeding while brushing the teeth. Headache Dizziness Weakness Nausea GI distress

Question 31

Most common adverse effect of antiplatelets

Answer 31

bleeding, which often occurs as increased bruising and bleeding while brushing the teeth.

Question 32

Adverse Effects of Aspirin

Answer 32

Nausea Dyspepsia Heartburn Epigastric discomfort GI bleeding Occult blood loss Dizziness Tinnitus Difficulty hearing

Question 33

Nursing Interventions for Antiplatelets

Answer 33

Suggest safety measures, including the use of an electric razor and avoidance of contact sports. Provide increased precautions against bleeding during invasive procedures; use pressure dressings and ice to decrease excessive blood loss caused by anticoagulants. Provide small frequent meals to relieve GI discomfort