Pharmacology Blood Thinners #1

Question

Which client would absolutely not be able to receive alteplase for the stroke symptoms they are experiencing?

Answers

  1. Recently taking a phosphodiesterase inhibitor
    • Rationale:

      This answer is not correct because phosphodiesterase inhibitors are not contraindicated in ischemic stroke or administration of alteplase. This medication is contraindicated if the client was experiencing chest pain (angin) with myocardial infarction and needed nitroglycerin therapy.

  2. Home medication of a chewable baby aspirin daily
    • Rationale:

      This answer is not correct because chewable aspirin is a treatment for an ischemic stroke. Although there are added bleeding risks, it is not contraindicated except in situations such as where an injury has occurred from trauma and recent surgery due to the risk of hemorrhage from clots being dissolved. It would be absolutely contraindicated in a client with a hemorrhagic stroke.

  3. A head injury associated with the stroke symptoms
    • Rationale:

      This answer is correct because alteplase is contraindicated in recent head traumas due to the risk of hemorrhage from clots being dissolved. Administration of alteplase to this client could cause hemorrhage and death. Therefore, this client should not receive this medication. Clients receiving this medication should be carefully monitored for bleeding.

  4. Computer tomography results indicating ischemia
    • Rationale:

      This answer is not correct because an ischemic stroke is the stroke that alteplase is designed to help due to its thrombolytic actions. It would be absolutely contraindicated to administer in a client with a hemorrhagic stroke.

Overview

Alteplase is a thrombolytic often given to clients experiencing an ischemic stroke. Due to the fact that all clots in the body are dissolved by this medication, the medication could not be given to a client with a recent head injury.

Explanation

Learning Outcomes

Alteplase is a medication used to effectively dissolve clots in the brain of the client with an ischemic stroke. This medication is potent and can be very dangerous if the client has had a recent surgery or injury from a trauma due to the risk of hemorrhage. Furthermore, this medication is never given to a client with a hemorrhagic stroke since the client would further hemorrhage and die. The client will be closely monitored for any symptoms of bleeding since this could become deadly in moments. Any needle sticks, such as for lab results, medication injections, etc. are not done except by means of an already established intravenous line due to the risk of bleeding.

Test Taking Tip

Understanding word parts helps the student understand medical terminology. Thrombolytics are “lytic” medications, which means thrombus material (clots) will be lysed or disintegrated.

Video Rationale