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1. Question
The nurse should report which assessment finding to the health care provider (HCP) before initiating thrombolytic therapy in a client with pulmonary embolism?
Correct
Answer: Option 3 is the correct answer.
Rationale: Thrombolytic therapy is contraindicated in a number of preexisting conditions in which there is a risk of uncontrolled bleeding, similar to the case in anticoagulant therapy. Thrombolytic therapy also is contraindicated in severe uncontrolled hypertension because of the risk of cerebral hemorrhage. Therefore, the nurse would report the results of the blood pressure to the HCP before initiating therapy.
Test-Taking Strategy: Focus on the subject, a contraindication for the use of thrombolytic therapy. Adventitious breath sounds, temperature of 99.4 °F (37.4 °C), and respiratory rate of 28 breaths/minute may be present in the client with pulmonary embolism but are not necessarily signs that warrant reporting before thrombolytic therapy is initiated.
Incorrect
Answer: Option 3 is the correct answer.
Rationale: Thrombolytic therapy is contraindicated in a number of preexisting conditions in which there is a risk of uncontrolled bleeding, similar to the case in anticoagulant therapy. Thrombolytic therapy also is contraindicated in severe uncontrolled hypertension because of the risk of cerebral hemorrhage. Therefore, the nurse would report the results of the blood pressure to the HCP before initiating therapy.
Test-Taking Strategy: Focus on the subject, a contraindication for the use of thrombolytic therapy. Adventitious breath sounds, temperature of 99.4 °F (37.4 °C), and respiratory rate of 28 breaths/minute may be present in the client with pulmonary embolism but are not necessarily signs that warrant reporting before thrombolytic therapy is initiated.
The goal of thrombolytic therapy is rapid restoration of flow in an occluded vessel by accelerating fibrinolytic proteolysis of the thrombus. Thrombolytic therapy is one part of an overall antithrombotic plan that frequently includes anticoagulants, antiplatelet agents and mechanical approaches to rapidly restore flow and prevent reocclusion.
