A nurse is caring for a client who is receiving bivalirudin IV for a PCI procedure. Which of the following laboratory tests should the nurse monitor to evaluate the effectiveness of the drug?

ECT.ECT stands for ecarin clotting time, which is a test that measures the anticoagulant effect of bivalirudin, a direct thrombin inhibitor.Bivalirudin is used for patients undergoing percutaneous coronary intervention (PCI) to prevent thrombotic complications.ECT is the most sensitive and specific test for monitoring bivalirudin therapy.

Choice A is wrong because PT stands for prothrombin time, which is a test that measures the extrinsic pathway of coagulation and the effect of warfarin, a vitamin K antagonist.PT is not affected by bivalirudin.

Choice B is wrong because INR stands for international normalized ratio, which is a standardized way of reporting PT results and the effect of warfarin.INR is also not affected by bivalirudin.

Choice C is wrong because aPTT stands for activated partial thromboplastin time, which is a test that measures the intrinsic pathway of coagulation and the effect of heparin, an indirect thrombin inhibitor.aPTT can be used to monitor bivalirudin therapy, but it is less sensitive and specific than ECT.

This statement by the client indicates a need for further teaching because aspirin can increase the risk of bleeding when taken with argatroban, which is an anticoagulant drug used to treat or prevent thrombosis in patients with heparin-induced thrombocytopenia (HIT). The client should avoid taking aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) unless prescribed by their health care provider.

Choice A is wrong because avoiding alcohol while taking argatroban is a correct statement.

Alcohol can also increase the risk of bleeding and should be avoided or limited by the client.

Choice C is wrong because notifying the dentist that the client is taking argatroban is a correct statement.

The client should inform their dentist and other health care providers about their medication history before any invasive procedures, as they may need to adjust or stop their argatroban dose to prevent excessive bleeding.

Choice D is wrong because checking the blood pressure regularly at home is a correct statement.

The client should monitor their blood pressure and other signs of bleeding, such as bruising, nosebleeds, blood in urine or stool, or prolonged bleeding from cuts or wounds.

The client should also report any symptoms of thrombosis, such as chest pain, shortness of breath, leg pain or swelling, or stroke-like symptoms.