The most common side effect of thrombolytic therapy is?

Appeared in: AIIMS Patna NO - 2020

Explanation

The primary mechanism of thrombolytic agents is to dissolve fibrin clots by activating plasminogen to form plasmin.
This action is not specific to pathological clots and can also dissolve necessary hemostatic plugs, leading to bleeding.
Hemorrhage (bleeding) is the most frequent and potentially most serious complication of this therapy.
Bleeding can be internal (e.g., intracranial, gastrointestinal) or external (e.g., from puncture sites).

Option A: Metabolic abnormalities are not a primary or direct side effect of thrombolytic agents, whose main action is on the coagulation system.
Option C: Compartment syndrome is caused by increased pressure within a muscle compartment, typically due to trauma, fractures, or severe swelling. It is not a direct pharmacological effect of thrombolytics.

Clinical Relevance

Nursing practice connection: Knowing Side effects of thrombolytic therapy helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses must conduct rigorous monitoring during and after thrombolytic administration. This includes checking vital signs every 15 minutes for the first hour, then every 30 minutes, and assessing for any neurological changes or signs of bleeding.
Early detection of bleeding is critical. If suspected, the nurse's immediate actions are to stop the infusion, notify the healthcare provider, and prepare for emergency interventions.
What if? If a patient receiving t-PA for a stroke suddenly complains of a severe headache and becomes drowsy, the nurse should suspect intracranial hemorrhage. The immediate priority is to stop the infusion and get an emergency CT scan of the head.

How to Approach the Question

First, identify the core concept of the question, which is the primary side effect of 'thrombolytic therapy'.
Recall the mechanism of action for thrombolytic drugs. Their purpose is to 'lyse' or break down thrombi (blood clots).
Consider the logical consequence of a drug that breaks down clots. If it breaks down the 'bad' clot, it can also break down 'good' clots that prevent bleeding elsewhere in the body.
Evaluate the options based on this mechanism. 'Internal bleeding' is a direct and logical consequence of this 'clot-busting' action.
Eliminate the other options as they are not directly related to the primary action of thrombolytics. Metabolic issues, compartment syndrome, and renal failure have different primary causes.

Concept Tested & Keywords

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Practise the full AIIMS Patna NO - 2020

Attempt every question from this paper in a timed mock, then review the full solution for each one.