A nurse is caring for client who has difficulty swallowing medications and is prescribed enteric-coated aspirin PO once daily. The client asks the medication can be crushed to make it easier to swallow. Which of the following responses should the nurse provide?

Crushing the medication would release all the medication at once, rather than over time."

Crushing the medication might cause you to have a stomachache or indigestion.

"Crushing the medication is a good idea, and I can mix in some ice cream for you."

"Crushing is unsafe, as it destroys the ingredients in the medication."

Answer and Explanation

The Correct Answer is B

A) Crushing the medication would release all the medication at once, rather than over time:. Enteric-coated aspirin is designed to bypass the stomach and release the medication in the small intestine to avoid irritation of the stomach lining. Crushing the tablet could potentially release the entire dose all at once, which could lead to gastrointestinal irritation, but this isn't the primary concern. The key issue is that crushing destroys the enteric coating, which is crucial for protecting the stomach.

B) Crushing the medication might cause you to have a stomachache or indigestion:
Enteric-coated medications are specifically designed to protect the stomach lining by delaying the release of the drug until it reaches the small intestine. Crushing the medication would destroy the enteric coating, which can lead to stomach irritation, upset, or even ulcer formation due to the direct exposure of the stomach lining to the medication. Therefore, crushing could cause significant discomfort or damage to the digestive system.

C) "Crushing the medication is a good idea, and I can mix in some ice cream for you.":
Crushing enteric-coated medications, such as aspirin, can lead to adverse effects like stomach irritation, ulceration, and poor absorption. The nurse should not recommend this method of administration without first consulting with the prescribing provider or pharmacist to explore alternatives.

D) "Crushing is unsafe, as it destroys the ingredients in the medication.":
Crushing does not destroy the active ingredients in the medication, but it does destroy the enteric coating, which is the key concern. The enteric coating's function is to prevent the aspirin from irritating the stomach. While it's important to recognize that crushing is unsafe, the reason is more about the loss of this protective coating rather than the destruction of the medication's active ingredients themselves.

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Correct Answer is D

Explanation

A) A client who has heart failure and peripheral edema:
While heart failure and peripheral edema are significant conditions that require medical attention, they are chronic issues that, in most cases, are not immediately life-threatening in an emergency department setting unless there is acute decompensated heart failure or signs of severe fluid overload or respiratory distress.

B) A client who reports urinary burning and a temperature of 29.2° C (102.5°F):
This client is febrile, which suggests an infection, possibly a urinary tract infection (UTI). Although fever and urinary burning are concerning, infection-related fevers generally don't pose an immediate life threat unless there is sepsis or severe systemic involvement. A temperature of 102.5°F is significant, but the client's condition is not as urgent as other life-threatening emergencies like an arrhythmia or severe cardiovascular instability.

C) A client who has cirrhosis of the liver and bruising on their arms:
Bruising in a client with cirrhosis of the liver could indicate bleeding tendencies, which is an important concern. However, unless there is active bleeding or signs of severe liver failure (e.g., confusion, ascites, jaundice), this is not an immediate, life-threatening situation.

D) A client who has a new onset of atrial fibrillation and a heart rate of 152/min:
A new onset of atrial fibrillation (AF) with a heart rate of 152/min is an immediate priority. This is a life-threatening arrhythmia that can lead to decreased cardiac output, risk of stroke, and hemodynamic instability. A heart rate of 152 beats per minute is dangerously high, which could lead to tachycardia-induced cardiomyopathy or cardiogenic shock. Immediate intervention is needed to manage the arrhythmia and prevent further complications.

A. Assessment B. Planning C. Evaluation D. Analysis

Correct Answer is B

Explanation

A) Assessment:
Assessment involves gathering and analyzing data about the client’s health status and needs. While gathering information from the social worker and physical therapist may be part of the assessment process, the actual collaborative work in preparing the discharge plan is more aligned with the planning phase of the nursing process.

B) Planning:
Planning is the correct answer because it involves formulating goals, interventions, and expected outcomes for the client’s care, including discharge projections. In this case, the nurse, social worker, and physical therapist are working together to develop a comprehensive discharge plan tailored to the client’s needs, which is a key part of the planning phase.

C) Evaluation:
Evaluation occurs after interventions are implemented to assess whether the goals have been met and the outcomes achieved. Since the nurse is still in the process of preparing the discharge plan, evaluation has not yet occurred.

D) Analysis:
Analysis is the process of interpreting assessment data to identify problems or needs. While analysis is part of the assessment phase, it does not describe the collaborative action of creating a discharge plan, which is clearly a planning task.

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A nurse is caring for client who has difficulty swallowing medications and is prescribed enteric-coated aspirin PO once daily. The client asks the medication can be crushed to make it easier to swallow. Which of the following responses should the nurse provide?

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