A 65-year-old female client with a long history of acute coronary syndrome (ACS) had two cardiac stents placed via percutaneous coronary intervention. After this procedure, she was started on aspirin 325 mg orally once daily and clopidogrel 75 mg orally once daily. The nurse is preparing to provide education about each of these drugs.
For each health teaching statement below, click a box to indicate whether it is Essential (necessary or appropriate drug information) or Unrelated (not relevant or appropriate drug information) for the client.
"Drink a glass of water after each dose of your new drug."
"Avoid taking other medications that can cause bleeding, such as NSAIDS like ibuprofen."
"Follow up with the prescribed laboratory testing needed to monitor your clotting values."
"Eat foods high in Vitamin K and calcium to help prevent clotting."
"Continue to take your newly prescribed medications until your prescriber tells you not to do so."
“Report any unexpected bleeding to your primary health provider."
The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"B"},"E":{"answers":"A"},"F":{"answers":"A"}}
Essential
1. "Avoid taking other medications that can cause bleeding, such as NSAIDs like ibuprofen." Both aspirin and clopidogrel increase the risk of bleeding. NSAIDs like ibuprofen can further increase this risk, so it is crucial to avoid them unless advised otherwise by a healthcare provider.
2. "Continue to take your newly prescribed medications until your prescriber tells you not to do so." Discontinuing aspirin and clopidogrel without medical advice can increase the risk of stent thrombosis and other complications. It is essential to follow the prescribed regimen strictly.
3. “Report any unexpected bleeding to your primary health provider." Monitoring for signs of bleeding (such as bruising, blood in the stool or urine, or unusual bleeding) is important due to the increased bleeding risk associated with these medications. Prompt reporting can help manage and mitigate serious complications.
Unrelated
1. "Drink a glass of water after each dose of your new drug." While staying hydrated is generally good advice, it is not specifically relevant to the efficacy or safety of aspirin and clopidogrel.
2. "Follow up with the prescribed laboratory testing needed to monitor your clotting values." Routine clotting tests (such as INR, PT, or aPTT) are not typically required for monitoring the effects of aspirin and clopidogrel, as these medications do not usually require lab monitoring like warfarin does.
3. "Eat foods high in Vitamin K and calcium to help prevent clotting." This advice is unrelated because Vitamin K can counteract the effects of anticoagulants like warfarin but does not affect the action of antiplatelet drugs like aspirin and clopidogrel. Calcium intake is also unrelated to the management of these medications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","D"]
Explanation
A. Prayer: Prayer and meditation are practices that focus on the mind-body connection and can be used for relaxation, stress reduction, and promoting inner peace. These practices are often included in CAM approaches.
B. Yoga: Yoga combines physical postures, breathing exercises, and meditation. It can improve flexibility, strength, balance, and overall well-being, making it a popular CAM therapy.
C. Massage: Massage therapy involves manipulating the soft tissues of the body to promote relaxation, pain relief, and improved circulation. It's a widely used CAM therapy.
D. Meditation: Meditation involves focusing your attention and quieting the mind. It can promote relaxation, reduce stress, and improve emotional well-being, aligning with CAM principles.
E. Ointments with a steroid base: Steroid creams are medications typically prescribed by doctors for specific skin conditions. While some natural remedies might be used topically in CAM, ointments with a steroid base wouldn't be considered a CAM therapy itself.
Correct Answer is D
Explanation
A. Diminished effect from warfarin: This is unlikely because displacement of warfarin from protein binding sites would increase its concentration in the bloodstream, potentially leading to increased anticoagulant effects and toxicity.
B. Diminished effect from paroxetine: This is also unlikely because displacement of paroxetine from protein binding sites would increase its concentration in the bloodstream, potentially leading to increased pharmacological effects and toxicity.
C. Increased effect, and toxicity from paroxetine: If paroxetine displaces warfarin from protein binding sites, it can increase the concentration of free warfarin in the bloodstream, leading to increased anticoagulant effects and potential toxicity.
D. Increased effect, and toxicity from warfarin: Correct. If warfarin is displaced from protein binding sites by paroxetine, it can increase the concentration of free warfarin in the bloodstream, leading to increased anticoagulant effects and potential toxicity.
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