Pharmacology Miscellaneous Neurological Condition Drugs #3

Question

A client is admitted to the hospital two hours after having an ischemic stroke. Which medication does the nurse anticipate the client to be given immediately?

Answers

  1. 1. Tenecteplase
    • Rationale:

      This answer is not correct because tenecteplase is commonly used in clients with myocardial infarctions to help dissolve active clots, not in clients with ischemic stroke. Alteplase is the gold standard for treatment of ischemic stroke.

  2. 2. Alteplase
    • Rationale:

      This answer is correct because alteplase (Activase), an IV injection of tissue plasminogen activator (tPA), is the gold standard for treatment of clients with ischemic stroke. Alteplase is a thrombolytic or “clot buster” administered to break up the blood clots in an ischemic stroke client’s brain to restore blood flow and function of the brain.

  3. 3. Warfarin
    • Rationale:

      This answer is not correct because warfarin is used to prevent further blood clots from forming. Warfarin is given as prevention. It is not a thrombolytic, like alteplase, which eliminates existing blood clots.

  4. 4. Acetaminophen
    • Rationale:

      This answer is not correct because acetaminophen is not used for clients with strokes, but used for clients with mild to moderate pain.

Overview

Alteplase is given as the gold standard for treatment of ischemic stroke to break up the blood clots.

Explanation

Learning Outcomes

Alteplase is a “clot buster” or IV thrombolytic administered to restore blood flow to the brain in clients with ischemic strokes. Research has shown that administering the medication within 4.5 hours of the onset of the stroke can significantly improve the outcome for clients with ischemic stroke. Since the medication breaks up all existing clots in the body, special criteria must be met and extreme bleeding precautions adhered to.

Test Taking Tip

Remember to watch and not be distracted by answers that might have similar characteristics, such as warfarin, an anticoagulant, which has bleeding risks and is associated with stroke prevention, but is extremely different from thrombolytics, which dissolve active clots.

Video Rationale