The client is experiencing a drug-drug interaction with streptokinase and another drug. Which other drug can cause a drug-drug interaction with streptokinase?

Correct Answer: C

Rationale: Step-by-step rationale: 1. Heparin is known to increase the risk of bleeding when used concomitantly with streptokinase. 2. Both drugs have anticoagulant properties, leading to a synergistic effect on bleeding risk. 3. Streptokinase enhances the activity of heparin, potentially causing excessive bleeding in the client. 4. This interaction highlights the importance of monitoring clotting parameters when these drugs are used together. Summary of incorrect choices: A: Cimetidine - Not known to interact significantly with streptokinase in terms of bleeding risk. B: Theophylline - Does not have a direct pharmacological interaction with streptokinase. D: Digoxin - Does not impact the bleeding risk associated with streptokinase.

Correct Answer: A

Rationale: Correct Answer: A (Nausea and vomiting) Rationale: Anti-arrhythmic drugs can affect the gastrointestinal system, leading to nausea and vomiting as common side effects. This is due to the drug's impact on the digestive tract and its receptors. Hypotension (choice B) is not a common side effect of anti-arrhythmic drugs as they are more likely to cause cardiac effects. Pro-arrhythmic effect (choice C) is a potential risk of anti-arrhythmic drugs but not a common side effect. Constipation (choice D) is not typically associated with anti-arrhythmic drugs, as they are more likely to affect the heart and not the digestive system.

Correct Answer: A

Rationale: The correct answer is A: Decreases preload. Organic nitrates dilate veins, reducing venous return to the heart and therefore decreasing preload. This helps to reduce the workload on the heart and improve oxygen supply to the myocardium. B: Increases afterload - Organic nitrates do not increase afterload. They actually reduce afterload by dilating arteries and reducing vascular resistance. C: Constricts arterioles - Organic nitrates mainly dilate both arteries and veins, causing vasodilation rather than arteriole constriction. D: Increases preload - Organic nitrates do the opposite by reducing preload through venous dilation.

Correct Answer: C

Rationale: The correct answer is C: Thrombocytopenia. IV heparin can cause a decrease in platelet count, leading to thrombocytopenia. This adverse reaction can result in an increased risk of bleeding. The nurse should monitor the client's platelet count regularly. Pulmonary embolism (A) and deep vein thrombosis (B) are conditions that heparin is used to prevent and treat, not adverse reactions of the drug. Neutropenia (D) is a decrease in neutrophils, not typically associated with heparin therapy.

Correct Answer: B

Rationale: The correct answer is B: It directly inhibits thrombin. Dabigatran (Pradaxa) is a direct thrombin inhibitor, preventing the conversion of fibrinogen to fibrin, thereby inhibiting the clotting cascade. This mechanism differs from antiplatelet drugs (A) that inhibit platelet aggregation, fibrinolytic medications (C) that dissolve existing clots, and drugs that interfere with clotting factors production (D) which is not the mechanism of action for dabigatran. By directly inhibiting thrombin, dabigatran has a more specific and targeted effect on the clotting process.