A nurse is teaching a client who has atrial fibrillation and is to start taking dabigatran.

Which of the following statements by the client indicates an understanding of the teaching?

Choice A reason:

Ketorolac is incorrect because it is an NSAID that is used for short-term pain relief. It has a higher risk of causing irritation to the stomach lining and is not recommended for clients with a history of peptic ulcers.

Choice B reason:

Acetaminophen is the correct answer. When caring for a client who reports a headache and has a history of a peptic ulcer, the nurse should administer Acetaminophen. Acetaminophen is an analgesic (pain reliever) and antipyretic (fever reducer) that does not have anti-inflammatory properties. It is a suitable option for pain relief in clients with a history of peptic ulcers because it is less likely to cause irritation to the stomach lining compared to nonsteroidal anti-inflammatory drugs (NSAIDs).

Choice C reason

Aspirin is not appropriate: Aspirin is an NSAID with anti-inflammatory, analgesic, and antipyretic properties. Like other NSAIDs, it can increase the risk of stomach irritation and should be avoided in clients with a history of peptic ulcers.

Choice D reason:

Ibuprofen is not the right option: Ibuprofen is another NSAID commonly used for pain relief and reducing inflammation and fever. Like other NSAIDs, it can irritate the stomach lining and is not recommended for clients with a history of peptic ulcers.

The correct answer is choice A, administer a fluid bolus.

Choice A rationale:

Administering a fluid bolus is appropriate when a client’s urine output is low, which in this case is less than the minimum expected output of 30 mL/hr. The dark yellow color of the urine also suggests dehydration or concentrated urine, which can be addressed with increased fluid intake.

Choice B rationale:

Initiating continuous bladder irrigation is typically done to clear the urinary tract of blood clots or debris following urologic surgery, not for low urine output or dark urine. Therefore, this intervention is not indicated based on the given scenario.

Choice C rationale:

Obtaining a urine specimen for culture and sensitivity is an action taken when there is a suspicion of a urinary tract infection. The scenario does not provide evidence of infection, such as fever or cloudy urine with a strong odor, so this would not be the first intervention to anticipate.

Choice D rationale:

Clamping the catheter tubing is done in preparation for catheter removal or to assess if the client can void without the catheter. It is not an appropriate intervention for low urine output or dark urine and could potentially cause bladder distention or discomfort.