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Alteplase (tPA, Activase) Nursing Considerations

Alteplase (tPA, Activase) Nursing Considerations

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Outline

Generic Name

Alteplase

Trade Name

tPA, Activase

Indication

MI, acute ischemic stroke, occluded central lines

Action

Converts plasminogen to plasmin which degrades the fibrin found in clots

Therapeutic Class

Thrombolytics

Pharmacologic Class

Plasminogen activators

Nursing Considerations

• Contraindicated in active bleeding
• Monitor closely for signs of bleeding (petechiae)
○ q 15 min X1hr o q 15-30 min X 8 hr
• Use caution with patient who have had recent surgery
• May cause intracranial hemorrhage
• Monitor for anaphylaxis
• Use caution with uncontrolled hypertension
• Assess neuro status during therapy

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Neuro

Concepts Covered:

Multisystem
Neurological
Nervous System
Emergency Care of the Neurological Patient
Central Nervous System Disorders – Brain
Cognitive Disorders
Neurologic and Cognitive Disorders
Medication Administration
Central Nervous System Disorders – Spinal Cord
Studying
Terminology
Peripheral Nervous System Disorders
Neurological Emergencies
Cardiac Disorders
Neurological Trauma
Emergency Care of the Trauma Patient
Shock

Study Plan Lessons

07.01 CVA (Cerebrovascular Accident/Stroke) for CCRN Review

07.02 Neuro Anatomy for CCRN Review

Acute Confusion

Adjunct Neuro Assessments

Altered Mental Status Nursing Mnemonic (AEIOU TIPS)

Altered Mental Status- Delirium and Dementia for Progressive Care Certified Nurse (PCCN)

Anticonvulsants

Autonomic Nervous System (ANS)

AVPU Mnemonic (The AVPU Scale)

Blood Brain Barrier (BBB)

Encephalopathies

Electroencephalography (EEG)

Increased Intracranial Pressure

Levels of Consciousness (LOC)

Mannitol (Osmitrol) Nursing Considerations

Multiple Sclerosis Symptoms Nursing Mnemonic (DEMYELINATION)

Neuro A&P Module Intro

Nervous System Anatomy

Nerve Transmission

Neuro Terminology

Neurological Disorders (Multiple Sclerosis, Myasthenia Gravis, Guillain-Barré Syndrome) for Certified Emergency Nursing (CEN)

Nursing Care Plan (NCP) for Guillain-Barre

Nursing Care Plan (NCP) for Meningitis

Nursing Care Plan (NCP) for Multiple Sclerosis (MS)

Nursing Care Plan (NCP) for Myasthenia Gravis (MG)

Seizure Causes (Epilepsy, Generalized)

Seizure Disorder for Progressive Care Certified Nurse (PCCN)

Seizure Management in the ER

Stroke Assessment (CVA)

Stroke Case Study (45 min)

Stroke Concept Map

Transient Ischemic Attack (TIA) for Certified Emergency Nursing (CEN)

07.05 Supratentorial Herniation: Cushings Triad for CCRN Review

Alteplase (tPA, Activase) Nursing Considerations

Cerebral Angiography

Cerebral Palsy (CP)

Brain Death v. Comatose

Cranial Nerve Mnemonic 01 Nursing Mnemonic (Olympic Opium Occupies Troubled Triathletes After Finishing Vegas Gambling Vacations Still High)

Cranial Nerve Mnemonic 02 Nursing Mnemonic (Oh Oh Oh To Touch And Feel Very Good Velvet AH!)

Head Trauma & Traumatic Brain Injury

Meningitis Assessment Findings Nursing Mnemonic (FAN LIPS)

Meropenem (Merrem) Nursing Considerations

Nursing Care and Pathophysiology for Meningitis

Nursing Care and Pathophysiology for Seizure

Nursing Care Plan (NCP) for Encephalopathy

Nursing Care Plan (NCP) & Interventions for Increased Intracranial Pressure (ICP)