A patient is receiving thrombolytic therapy, and the nurse monitors the patient for adverse effects. What is the most common undesirable effect of thrombolytic therapy?

Correct Answer: D

Rationale: The most common undesirable effect of thrombolytic therapy is internal and superficial bleeding. Thrombolytic medications work by dissolving blood clots, which can lead to an increased risk of bleeding. This bleeding can occur internally, such as in the gastrointestinal tract or brain, or externally, in the form of bruising or easy bleeding from cuts or wounds. It is crucial for healthcare providers to closely monitor patients receiving thrombolytic therapy for signs of bleeding and to promptly address any concerns to prevent complications. Dysrhythmias, nausea and vomiting, and anaphylactic reactions are less common adverse effects associated with thrombolytic therapy compared to bleeding.

Correct Answer: A

Rationale: In this scenario, with the patient experiencing leg pain while taking atorvastatin (Lipitor), a medication commonly used to treat high cholesterol, it is essential to prioritize the patient's safety and well-being. Leg pain can be a sign of a rare but serious side effect known as rhabdomyolysis, which can lead to muscle breakdown and potentially affect kidney function. Therefore, it is crucial to immediately discontinue the medication (atorvastatin) and have the patient come in to the clinic to be seen today for further evaluation and management. This will allow healthcare providers to assess the severity of the leg pain, conduct necessary tests, and determine the appropriate course of action to ensure the patient's health and safety.

Correct Answer: B

Rationale: Steady-state concentration is reached after 4-5 half-lives, when drug input equals output. Digoxin's half-life is 40 hours (1.67 days). Four half-lives is 4 × 40 = 160 hours (6.67 days), and five is 200 hours (8.33 days). Over 90% steady state occurs around 4 half-lives, roughly 6-7 days. Two days (48 hours) is only ~1.2 half-lives, far too short. Ten days (~6 half-lives) exceeds 90%, but 7 days (~4.2 half-lives) aligns with >90% (e.g., 94% at 4 half-lives). Fourteen or 18 days overshoot unnecessarily. Seven days balances precision and practicality, guiding digoxin dosing timelines in heart failure or arrhythmias.

Correct Answer: B

Rationale: Dizziness is a common side effect of many blood pressure medications, particularly during the initial days of therapy. This side effect increases the patient's risk of falls or other injuries, especially in elderly patients or those with mobility issues. The nursing diagnosis 'Risk for injury' is the most appropriate because it directly addresses the potential harm caused by dizziness. While 'Activity intolerance' and 'Self-care deficit' may be relevant in some cases, they do not specifically address the immediate risk posed by dizziness. 'Disturbed body image' is unrelated to this scenario. Therefore, 'Risk for injury' is the best diagnosis to guide nursing interventions, such as monitoring the patient and educating them on safety measures.

Correct Answer: D

Rationale: Peripheral mediators of pain can sensitize nociceptors and contribute to the perception of pain. Histamine, bradykinin, and prostaglandins are all examples of peripheral mediators that can induce pain. Amino acids, on the other hand, are not typically considered peripheral mediators of pain. While amino acids are important for many physiological processes in the body, they are not generally associated with the direct modulation of pain signaling pathways in the periphery.