The nurse is caring for a client diagnosed with iron deficiency anemia as the result of a gastrointestinal (GI) bleed. What discharge instruction should the nurse provide if this client is also prescribed aspirin 81 mg daily?
Take a baby aspirin with a full glass of cold water at bedtime.
You can take 81 mg of enteric coated aspirin with orange juice at lunch time.
It's ok to take the aspirin with some ginseng tea in the evening.
Take the aspirin with a glass of milk or food in the morning.
The Correct Answer is D
Choice A reason: Taking a baby aspirin with a full glass of cold water at bedtime is not a good discharge instruction for this client. Aspirin can increase the risk of bleeding, especially in the stomach and intestines. ¹ Taking aspirin at bedtime may increase the exposure of the GI mucosa to the drug and worsen the bleeding. ² Cold water may also irritate the stomach lining and cause discomfort.
Choice B reason: Taking 81 mg of enteric coated aspirin with orange juice at lunch time is not a good discharge instruction for this client. Enteric coated aspirin is designed to dissolve in the small intestine, not the stomach, to reduce the risk of GI bleeding. ³ However, orange juice is acidic and may damage the coating and release the aspirin in the stomach. ⁴ This may increase the bleeding and cause pain or ulcers.
Choice C reason: Taking the aspirin with some ginseng tea in the evening is not a good discharge instruction for this client. Ginseng is an herbal supplement that may interact with aspirin and increase the risk of bleeding. ⁵ Taking the aspirin in the evening may also have the same drawbacks as taking it at bedtime, as explained in choice A.
Choice D reason: Taking the aspirin with a glass of milk or food in the morning is the best discharge instruction for this client. Milk and food can help protect the stomach lining from the irritating effects of aspirin and reduce the risk of bleeding. Taking the aspirin in the morning can also minimize the exposure of the GI mucosa to the drug during the night, when the stomach is empty and more vulnerable. ²
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: This is a high-fat, high-sodium, and high-calorie meal that is not suitable for a client with hypertension. Fried foods, processed meats, and baked beans are sources of saturated fat and sodium that can raise blood pressure and cholesterol levels. Cake is a source of added sugar that can contribute to obesity and diabetes.
Choice B reason: This is a moderate-fat, moderate-sodium, and moderate-calorie meal that is not ideal for a client with hypertension. Fried flounder and tomato soup are sources of fat and sodium that can increase blood pressure. White rice is a refined carbohydrate that can spike blood sugar levels and increase the risk of diabetes.
Choice C reason: This is a high-fat, high-sodium, and high-calorie meal that is not appropriate for a client with hypertension. Barbecue pulled pork sandwich, mashed potatoes, and ice cream are sources of saturated fat and sodium that can elevate blood pressure and cholesterol levels. Fresh green beans are the only healthy component of this meal.
Choice D reason: This is a low-fat, low-sodium, and low-calorie meal that is suitable for a client with hypertension. Baked tuna, fresh broccoli, brown rice, and fresh cantaloupe are sources of lean protein, fiber, complex carbohydrates, vitamins, minerals, and antioxidants that can lower blood pressure and cholesterol levels, prevent obesity and diabetes, and promote cardiovascular health.
Correct Answer is A
Explanation
Choice A reason: This is the correct answer. Stool for occult blood is a diagnostic test that detects the presence of hidden blood in the feces. This can indicate bleeding in the gastrointestinal tract, which is the most common cause of chronic iron deficiency anemia. Iron deficiency anemia is a condition where the body does not have enough iron to produce hemoglobin, the protein that carries oxygen in the red blood cells.
Choice B reason: Vitamin B12 level is not the diagnostic test that is used to detect the most common cause of chronic iron deficiency anemia. Vitamin B12 level is a blood test that measures the amount of vitamin B12 in the body. Vitamin B12 is a nutrient that is essential for the production of red blood cells and the maintenance of the nervous system. Vitamin B12 deficiency can cause pernicious anemia, a type of megaloblastic anemia where the red blood cells are large and immature.
Choice C reason: Schilling's test is not the diagnostic test that is used to detect the most common cause of chronic iron deficiency anemia. Schilling's test is a urine test that evaluates the absorption of vitamin B12 in the body. It involves giving the client an oral dose of radioactive vitamin B12 and an intramuscular injection of non-radioactive vitamin B12. The urine is then collected and measured for the amount of radioactive vitamin B12. Schilling's test can help diagnose pernicious anemia and other causes of vitamin B12 malabsorption.
Choice D reason: Bone marrow aspiration study is not the diagnostic test that is used to detect the most common cause of chronic iron deficiency anemia. Bone marrow aspiration study is a procedure that involves taking a sample of bone marrow from the hip or sternum and examining it under a microscope. Bone marrow is the soft tissue inside the bones that produces blood cells. Bone marrow aspiration study can help diagnose various blood disorders, such as leukemia, lymphoma, and aplastic anemia.
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