A patient diagnosed with intermittent claudication will be ...

[moongchi]

A patient diagnosed with intermittent claudication will be discharged to home on cilostazol (Pletal). Which of the following statements made by the patient indicates a need for further discharge instruction?
 
  a. I will take the cilostazol with grapefruit juice.
  b. Headache may be a side effect of the cilostazol.
  c. I will take the cilostazol 30 minutes before breakfast and 30 minutes before dinner.
  d. I should expect less pain and cramping in my legs when walking.

Question 2

A prescriber orders treatment with streptokinase for a patient admitted to the emergency department with an evolving myocardial infarction. Which of the following represents an appropriate action by the nurse?
 
  a. If hypotension develops during streptokinase infusion, the rate of infusion should be increased.
  b. Because one third of patients receiving streptokinase develop fever, aspirin should be administered prophylactically.
  c. If the patient develops urticaria and flushing, the nurse should prepare for administration of an antihistamine.
  d. Intramuscular injections should not be given while the streptokinase is infusing; however, subcutaneous injections may be given.

[Benayers]

Answer to Question 1

ANS: A
Cilostazol levels can be increased by grapefruit juice.
Headache is the most common adverse effect of cilostazol (34).
The usual dosage of cilostazol is 100 mg twice daily, taken 30 minutes before or 2 hours after breakfast and the evening meal.
Because cilostazol promotes vasodilation by inhibiting PDE3 in blood vessels, the patient will have less pain and cramping during activity.

Answer to Question 2

ANS: C
Streptokinase is a foreign protein extracted from cultures of streptococci, and antibodies may form. Consequently, an allergic reaction may occur, with manifestations such as urticaria, itching, flushing, and headache.
If hypotension develops during streptokinase infusion, the rate of infusion should be decreased.
Temperature elevation occurs in about one third of patients receiving streptokinase and should be treated with acetaminophen rather than aspirin to avoid further risk of bleeding.
Both subcutaneous and intramuscular injections should be avoided because of the risk for bleeding from puncture sites.

[moongchi]

Excellent

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