The prescriber has ordered thrombolytic therapy for a patient. ...

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The prescriber has ordered thrombolytic therapy for a patient. The nurse understands that patients for whom thrombolytic agents are absolutely contraindicated are those with history of
 
  a. peptic ulcer.
  b. subarachnoid hemorrhage.
  c. ischemic stroke 1 year ago.
  d. cardiac dysrhythmias.

Question 2

A patient with epistaxis and a history of hemophilia A is admitted to the unit and is scheduled for replacement therapy. The nurse should prepare to administer
 
  a. tranexamic acid (Cyklokapron).
  b. aminocaproic acid (Amicar).
  c. desmopressin (Stimate).
  d. factor VIII.

[britb2u]

Answer to Question 1

ANS: B
An absolute contraindication to thrombolytic therapy is any prior intracranial hemorrhage, such as a subarachnoid hemorrhage.
A history of peptic ulcer or an ischemic stroke 1 year ago is a relative contraindication. Thrombolytics can be administered with caution.
No contraindication exists to administration of thrombolytics to a patient with cardiac dysrhythmias.

Answer to Question 2

ANS: D
The cornerstone of treatment for hemophilia A is replacement therapy with factor VIII.
Tranexamic acid and aminocaproic acid are antifibrinolytic agents that act primarily by preventing the formation of plasmin from its precursor.
Desmopressin promotes the release of factor VIII from the vascular endothelium and has the advantage of being cheaper than factor VIII. Also, it can be administered by nasal spray as well as by IV infusion. However, repeated use of desmopressin can deplete stored factor VIII.

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TYSM

[patma1981]

Excellent