For a client diagnosed with peripheral arterial disease who has been taking aspirin 81 mg daily prophylactically for several months, which assessment finding is of most concern?

Hemoglobin is 7.1 g/dL on today's laboratory report.

There are small areas of ecchymosis on the client's upper extremities.

Platelet count is 148,000/uL on today's laboratory report.

The client complains of gastrointestinal discomfort after taking the medication.

Answer and Explanation

The Correct Answer is A

Choice A Reason
A hemoglobin level of 7.1 g/dL is significantly lower than the normal range, which is typically around 13.8 to 17.2 g/dL for men and 12.1 to 15.1 g/dL for women. This finding is concerning as it indicates severe anemia, which can be a life-threatening condition requiring immediate intervention. Anemia can lead to tissue hypoxia as the blood's capacity to carry oxygen is diminished. In the context of peripheral arterial disease, where blood flow is already compromised, anemia can exacerbate symptoms and increase the risk of ischemic events.

Choice B Reason
Ecchymosis, or bruising, on the client's upper extremities could be a result of the antiplatelet effects of aspirin, which inhibits platelet aggregation and prolongs bleeding time. While this is a concern and warrants monitoring, it is not as immediately life-threatening as severe anemia. However, it does indicate a risk of bleeding complications, which should be addressed by the healthcare provider.

Choice C Reason
A platelet count of 148,000/uL is at the lower end of the normal range, which is approximately 150,000 to 450,000 platelets per microliter of blood. This finding should be monitored, especially in the context of aspirin therapy, which can affect platelet function. However, it is not as critical as the low hemoglobin level.

Choice D Reason
Gastrointestinal discomfort is a common side effect of aspirin due to its irritation of the stomach lining. While this symptom can be uncomfortable and may lead to more serious gastrointestinal issues such as ulcers or bleeding, it is typically not as urgent as severe anemia. The client should be evaluated for potential gastrointestinal complications of aspirin therapy.

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Correct Answer is A

Explanation

Choice a reason:
Increasing fiber intake is crucial for clients with diverticular disease. A high-fiber diet softens the stool and helps it pass more easily, reducing the pressure in the digestive tract. Fresh fruits and vegetables are excellent sources of fiber and other nutrients essential for maintaining a healthy digestive system. The Dietary Guidelines for Americans recommend a dietary fiber intake of 14 grams per 1,000 calories consumed, which equates to 28 grams per day for a 2,000-calorie diet.

Choice b reason:
While avoiding foods high in sugar is generally good advice for overall health, it is not specifically related to the management of diverticular disease. There is no direct link between sugar intake and the symptoms or complications of diverticular disease. However, a diet high in sugar can contribute to obesity, which is a risk factor for the development of diverticulosis.

Choice c reason:
Decreasing fluid intake is not recommended for clients with diverticular disease. In fact, adequate hydration is essential when increasing fiber intake. Fluids help fiber work better by allowing it to absorb water and expand, aiding in easier passage through the intestines.

Choice d reason:
The previous belief that small seeds and nuts should be avoided by individuals with diverticular disease has been debunked. Recent studies have shown that these foods do not increase the risk of complications and are not harmful to individuals with this condition. Therefore, this advice is outdated and no longer considered necessary as part of dietary teaching for diverticular disease.

A. Maintain normal salt and fluid intake in the diet. B. Drink twice the usual amount of fluids daily. C. Avoid eating aged cheese, processed meats, and red wine. D. Double the lithium dose if diarrhea or vomiting occurs.

Correct Answer is A

Explanation

Choice A Reason:
Maintaining normal salt and fluid intake is crucial for patients on lithium. Lithium can affect sodium levels in the body, and consistent sodium intake helps to keep lithium levels stable. Patients should be advised to drink adequate fluids to prevent dehydration but avoid excessive fluid intake, which could alter lithium levels and potentially lead to toxicity¹²³⁴.

Choice B Reason:
Drinking twice the usual amount of fluids daily is not recommended for patients on lithium unless directed by a healthcare provider. Excessive fluid intake can lead to changes in lithium levels and increase the risk of lithium toxicity. Patients should aim to consume a sufficient amount of fluids to stay hydrated, especially in situations that may lead to dehydration, such as during hot weather or illness.

Choice C Reason:
Avoiding aged cheese, processed meats, and red wine is generally advised for patients taking monoamine oxidase inhibitors (MAOIs), not lithium. These foods can contain high levels of tyramine, which can interact with MAOIs. However, there are no specific dietary restrictions for lithium regarding these foods. Patients should follow a balanced diet and consult with their healthcare provider for personalized dietary advice.

Choice D Reason:
Doubling the lithium dose if diarrhea or vomiting occurs is incorrect and potentially dangerous. If a patient experiences diarrhea or vomiting, it can affect lithium absorption and increase the risk of toxicity. Instead, patients should contact their healthcare provider for guidance. Adjustments to the medication regimen should only be made under medical supervision.

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For a client diagnosed with peripheral arterial disease who has been taking aspirin 81 mg daily prophylactically for several months, which assessment finding is of most concern?

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a client who has just been diagnosed with diverticular disease. What dietary teaching will the nurse provide?

Correct Answer is A

Explanation

The nurse's teaching plan for a client taking lithium should include instructions to:

Correct Answer is A

Explanation

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