Chapter 26: Thrombolytic Therapy

Question 1

Major side effects of all Thrombolytics:

Answer 1

1. Bleeding at injection site
2. GI bleeds
3. Hemorrhagic stroke

Question 2

Antidote for Thrombolytics

Answer 2

1. Aminocaproic Acid: inhibits action of plasminogen into plasmin.
2. (If aminocaprioic acid fails) Platelets or Coagulation Factors

Question 3

Contraindications of Thrombolytics

Answer 3

• active internal bleeding
• aortic dissection
• recent trauma within 3 months
• HX of Intracranial hemorrhage or ischemic stroke within 3 months
• coagulopathies
• blood disorders
• before major surgeries

Question 4

Caution with Thrombolytics

Answer 4

• patients 75yr and older
• severe HTN
• pericarditis
• acute peptic ulcer
• diabetic retinopathy
• liver disease
• pregnancy/ breast feeding
• patients on anticoagulants and antiplatelets

Question 5

Nursing consideration before Thrombolytic administration.

Answer 5

• Baseline assessment: vitals, cardiac and neuro status.
• Recent labs: cbc, hematocrit, PT, aPTT & INR, renal & hepatic functions.
• place on ECG Monitor continuously

Question 6

What do you need to monitor before starting thrombolytic therapy to a patient with Myocardial Infarction?

Answer 6

Cardiac enzymes

Question 7

What do you need to check before starting thrombolytic therapy to a patient with Pulmonary Embolism?

Answer 7

Review the recent ABGs