A nurse is caring for a client who has end-stage kidney disease.
The client's adult child asks the nurse about becoming a living kidney donor for their parent.
Which of the following conditions in the child's medical history should the nurse identify as a contraindication to the procedure?

Choice A rationale:

Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) and can increase the risk of bleeding when used with warfarin, which is an anticoagulant medication. Combining these two medications can lead to excessive bleeding and is considered incompatible.

Choice B rationale:

Magnesium hydroxide is an antacid and does not have significant interactions with warfarin. It does not affect the anticoagulant properties of warfarin.

Choice C rationale:

Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor used to treat high blood pressure and heart failure. It does not have a significant interaction with warfarin.

Choice D rationale:

Propranolol is a beta-blocker used to treat high blood pressure, angina, and other heart conditions. It does not have a significant interaction with warfarin.

Choice A rationale:

An angiocatheter is not appropriate for accessing an implanted venous access port. Angiocatheters are large-bore catheters designed for rapid fluid administration and are typically used for peripheral venous access. They are not suitable for accessing the small, specialized ports used for central venous access.

Choice B rationale:

A 25-gauge needle is too small for accessing an implanted venous access port. While smaller gauge needles are suitable for delicate procedures and patients with fragile veins, they might not provide adequate flow for certain therapies or blood draws. Accessing a port with a needle that is too small can lead to increased pressure, potentially damaging the port or causing discomfort to the patient.

Choice C rationale:

A butterfly needle is also not the best choice for accessing an implanted venous access port. Butterfly needles, also known as winged infusion sets, are commonly used for short-term peripheral venous access. They are not designed for accessing implanted ports, which require a noncoring needle for precise and safe access without damaging the port membrane.

Choice D rationale:

(Correct Choice) A noncoring needle, also known as a Huber needle, is the correct choice for accessing an implanted venous access port. Noncoring needles have a specially designed tip that creates a smaller puncture hole, reducing damage to the port membrane and minimizing patient discomfort. They are specifically designed for accessing ports and are the standard choice for this procedure.