Thrombolytics Flashcards
The following flashcards are going to be on the simple nursing video
What is a thrombolytic?
the only clot-busting medication!
what are medications that are thrombolytics?
- give me names and what they typically end with
alteplase
reteplase
streptokinase
TPA!
when is the only time we can give thrombolytic?
what is the window of usage?
3-4.5 hours from onset of symptoms
what is the biggest risk factor of thrombolytic?
bleeding
what are the big no no that we can not do when giving a thrombolytic?
no injections what so ever
- no more additional IV
- no subq
- no Ims
- no abgs
where or what is the only location we can give these thrombolytic medications and why?
these drugs can only be given in a compressible site like a peripheral IV to be able to compress it incase it bleeds
what are absolute contradictions for patients who are going to receive thrombolytic? (3)
Active bleeding- peptic ulcer
( women menstruating is fine ^ )
uncontrolled hypertension 180/110+
recent surgery within 2 weeks
before we even give the medication we want to clarify the prescription with the provider, we can also follow the 3 A’s to talk about a patient history. which stand for?
A- accidents or recent trauma
A - aneurysm or history of hemorrhage stoke
A - AV malformation
the following flashcards are going to be based on the notes that freshi took back in 410
for a patient who is having an MI
- typically you want to thrombolytic therapy as the second option if PCI can not be done
within a ___min or arrival
30
what is the criteria for a thrombolytic therapy for an MI?
chest pain less than 12 hours and 12 lead shows STEMI
the following information is going to be on the NCLEX BOOK
before administering the medication, we want to collect what labs?
aPTT,PT, Firbinogen, hematocrit, and platelet count
before adminsitering what type of head to toe are we mainly focusing on ?
“skin” for any bleeding, but really looking at everything if there is blood in it, like any blood in urine or stool
what are the first signs and symptoms to note when we notice the patient is having internal bleeding or overall bleeding?
change in mental status, active bleeding site, hypotension, tachycardia
if the patient is activatly bleeding after administration what do we do?
compress the site, give an antidote and call doctor
what is the antidote to thrombolytics?
aminocaprioic acid
after the administration, what are we going to educate the patient on?
avoiding heavy lifting
brush teeth gently
use an electric razor
what is the patho of a thrombolytic?
converting plasminogen to plasmin, which destroys fibrin in the blood clots
the following flashcards are going to be on the pharmacology textbook given to us last semester for pharmacology
how do we administer the thrombolytic? time frame-wise and with what ?
through a peripheral IV
10% of dose and IV bolus over 1 min
90% infused over an hour
typically peaks 5-10mins
duration lasting 1 hour
onset is immediate
we want to examine the patient for active bleeding for the first 24hours after the medication, this should be done ___for first hour, ____mins until the 8th hour, then ___
15mins
30mins
hourly
we want to avoid administering what other medications that increase the risk of bleeding for these patients?
anticoagulants
anti plateltes
NSAIDS
why do we want to monitor the ECG after thrombolytic medication?
it can show reperfusion dysrhythmia ( which is normal but should be treated with antidysrhythmic medications ) as the blood clot is dissolving
