Alteplase is a fibrinolytic agent that is administered to patients who have had an STEMI. If the

medication is effective, the patient’s chest pain will resolve because the medication dissolves the

thrombus in the coronary artery and results in reperfusion of the myocardium. Bleeding is a major

complication of fibrinolytic therapy. Signs of major bleeding include decreased level of

consciousness, blood in the urine or stool, and increased heart rate with decreased blood pressure.

The 45-yr-old depressed man with a high-stress job is at the highest risk for CAD. Studies

demonstrate that depression and stressful states can contribute to the development of CAD.

Elevated HDL levels and low homocysteine levels actually help to prevent CAD. Although a

sedentary lifestyle is a risk factor, a BMI of 23 kg/m2 depicts normal weight, and thus the patient with

two risk factors is at greatest risk for developing CAD.

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CH 33: CAD

A 52-yr-old male patient has received a bolus dose and an infusion of alteplase (Activase) for an

ST-segment elevation myocardial infarction (STEMI). Which patient assessment would determine

the effectiveness of the medication?

A. Presence of chest pain Correct

B. Blood in the urine or stool Incorrect

C. Tachycardia with hypotension

D. Decreased level of consciousness

Which individuals would the nurse identify as having the highest risk for coronary artery disease

(CAD)?

A. A 45-yr-old depressed man with a high-stress job Correct

B. A 60-yr-old man with below normal homocysteine levels

C. A 54-yr-old woman vegetarian with elevated high-density lipoprotein (HDL) levels

D. A 62-yr-old woman who has a sedentary lifestyle and body mass index (BMI) of 23

kg/m2 Incorrect