A client with deep vein thrombosis (DVT) is receiving a continuous heparin IV infusion. The client now has tarry, black diarrhea and reports abdominal pain. Which actions should the nurse implement? Select all that apply.

Choice A reason: Understanding the reason for taking the aspirin is crucial because aspirin may be prescribed for various reasons, such as pain relief, anti-inflammatory purposes, or cardiovascular protection. Knowing the reason helps the nurse assess if ibuprofen is a suitable substitute or if additional interventions are needed.

Choice B reason: While the presence of gastric pain is important, it is secondary to understanding the underlying reason for aspirin use.

Choice C reason: Assessing the amount of pain control achieved with ibuprofen is important for managing the client's symptoms, but it is not the first priority.

Choice D reason: Knowing the dosage of ibuprofen taken is essential for determining if the client is taking an appropriate amount, but it comes after understanding the initial indication for aspirin use.

Choice A reason: Checking the client's current fingerstick blood glucose is important to determine if the confusion and weakness are due to hypoglycemia (low blood sugar) or hyperglycemia (high blood sugar).

Choice B reason: Obtaining blood pressure and heart rate is useful for a general assessment but is secondary to assessing blood glucose levels in this scenario.

Choice C reason: Administering a PRN dose of regular insulin is not appropriate without first determining the client's blood glucose level. If the client is hypoglycemic, insulin could worsen the condition.

Choice D reason: Giving the client 4 ounces (120 mL) of orange juice is a quick way to raise blood sugar levels if the client is hypoglycemic.

Choice E reason: Providing diet carbonated soda is not effective for treating hypoglycemia because it does not contain sugar to raise blood glucose levels.