Author Question: The patient receives reteplase (Retavase) intravenously (IV). The nurse assesses the patient for ... (Read 16 times)

Collmarie

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The patient receives reteplase (Retavase) intravenously (IV). The nurse assesses the patient for orientation and level of consciousness. The patient's wife asks the nurse why this is being done.
 
  What does the nurse indicate as the reason for the assessment?
  1. The medication can alter fluid balance; this affects orientation and level of consciousness.
  2. The medication can cause bleeding in the brain; this affects orientation and level of consciousness.
  3. The medication causes hypoglycemia; this affects orientation and level of consciousness.
  4. The medication decreases oxygen to the brain; this decreases orientation and level of consciousness.

Question 2

The patient is receiving diltiazem (Cardizem) and wants to know why he developed a headache after taking the medication. What is the best response by the nurse?
 
  1. Diltiazem (Cardizem) causes the blood vessels in your brain to widen; giving you the headache.
  2. Diltiazem (Cardizem) increases prostaglandin synthesis; giving you the headache.
  3. Diltiazem (Cardizem) releases Substance P, activating pain receptors in your brain and giving you the headache.
  4. Diltiazem (Cardizem) causes the blood vessels in your brain to narrow; giving you the headache.



Sweetkitty24130

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Answer to Question 1

Correct Answer: 2
Rationale: Cerebral hemorrhage is a concern with reteplase (Retavase) therapy; the nurse must assess for changes in mental and neurological status. Reteplase (Retavase) does not decrease oxygen to the brain. Reteplase (Retavase) does not cause hypoglycemia. Reteplase (Retavase) does not alter fluid balance in the body.

Answer to Question 2

Correct Answer: 1
Rationale: Side effects of diltiazem (Cardizem) are generally not serious and are related to vasodilation: headache, dizziness, and edema of the ankles and feet. Side effects of diltiazem (Cardizem) are related to vasodilation, not vasoconstriction. Diltiazem (Cardizem) does not alter prostaglandin synthesis. Diltiazem (Cardizem) does not lead to a release of Substance P.



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Collmarie

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Both answers were spot on, thank you once again




 

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