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 ["6.0"]
Explanation
To find the volume of amoxicillin solution the nurse needs to administer, we can divide the desired dose (300 mg) by the concentration of the solution (250 mg/5 mL).
Here's the calculation:
Amoxicillin volume (mL) = Desired dose (mg) / Concentration (mg/mL) Amoxicillin volume (mL) = 300 mg / 250 mg/5 mL
Since we're dividing by a fraction, it's mathematically equivalent to multiply by the reciprocal of the fraction. The reciprocal of 250 mg/5 mL is 5 mL/250 mg.
Amoxicillin volume (mL) = 300 mg * (5 mL / 250 mg)
Cancel out the milligrams (mg) units:
Amoxicillin volume (mL) = 300 mg / 250 mg * 5 mL
Amoxicillin volume (mL) = 1.2 mL (rounded to one decimal place)
However, since we are dealing with medication, it's best to round to the nearest whole number for accuracy in administering the dose.
Therefore, the nurse should administer 6.0 mL of amoxicillin oral solution.
Correct Answer is D
Explanation
A. Temperature of 100.8 Degrees Fahrenheit (38.2 Degrees Celsius): Fever can indicate a potential adverse reaction to the medication or may be a sign of infection, which could complicate the patient's condition. While a fever can be a sign of an infection, it's not a typical adverse effect for alteplase
B. Skin rash with urticaria: Skin rash and urticaria (hives) can indicate an allergic reaction to alteplase. Allergic reactions can range from mild to severe and may necessitate discontinuation of the medication and administration of appropriate treatment, such as antihistamines or corticosteroids, depending on the severity of the reaction but it's less common than bleeding.
C. Wheezing with labored breathing: Wheezing and labored breathing can indicate a severe allergic reaction or anaphylaxis to alteplase but again, bleeding is a more prominent concern.
D. Bruising and epistaxis: Alteplase increases the risk of bleeding due to its thrombolytic activity. Bruising and epistaxis (nosebleeds) are common manifestations of bleeding associated with alteplase therapy. Monitoring for these signs helps detect potential bleeding complications early, allowing for prompt intervention to minimize further bleeding and manage the patient's condition appropriately.
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