The nurse is caring for a client who has been taking aspirin 81mg PO daily for the last six months. Which clinical findings are of most concern? (SELECT ALL THAT APPLY)

Temperature elevation of 100.4 ORGAN

Hemoglobin decrease from 128g/dl to 9.5g/dl

Serum potassium increase from 3.5 mEq/L 4.5 mEq/L

Gastrointestinal discomfort prior to eating breakfast

Several areas of ecchymosis on upper and lower extremities

Answer and Explanation

Correct Answer : B,E

A. Temperature elevation of 100.4°F: While a slight fever can indicate infection or inflammation, it is not an immediate concern related to aspirin use. It requires monitoring but is not as critical as other findings.

B. Hemoglobin decrease from 128 g/dL to 5.5 g/dL: This significant drop in hemoglobin indicates severe anemia, which is a major concern and may suggest gastrointestinal bleeding, a known risk of long-term aspirin use.

C. Serum potassium increase from 3.5 mEq/L to 4.5 mEq/L: This level is still within the normal range and does not indicate a significant clinical issue. Normal potassium levels do not raise immediate concern.

D. Gastrointestinal discomfort prior to eating breakfast: While gastrointestinal discomfort can be a side effect of aspirin, it is not immediately alarming unless associated with more severe symptoms like bleeding or ulceration.

E. Several areas of ecchymosis on upper and lower extremities: This finding is concerning as it may indicate bleeding issues due to thrombocytopenia or increased bleeding tendency associated with aspirin therapy.

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Correct Answer is B

Explanation

A) "You can take 81 mg of enteric coated aspirin with orange juice at lunch time": While enteric-coated aspirin can help reduce gastrointestinal irritation, taking it with orange juice is not advisable. Citrus can increase gastric acidity, which might irritate the GI tract further, especially in a patient with a history of GI bleeding.

B) "Take the aspirin with a glass of milk or food in the morning": This instruction is appropriate as taking aspirin with food or milk can help minimize gastrointestinal irritation and promote safer use, especially in a client with iron deficiency anemia from a GI bleed. It also helps with absorption and can reduce the risk of an upset stomach.

C) "Take a baby aspirin with a full glass of cold water at bedtime": Taking aspirin with only water, particularly at bedtime, may increase the risk of gastric irritation and does not provide the protective effect that food or milk would. This is not the best practice for someone with a history of GI issues.

D) "It's ok to take the aspirin with some ginseng tea in the evening": Ginseng can interact with blood-thinning medications and may increase bleeding risk. Advising the client to combine aspirin with ginseng tea could be harmful, especially given their history of GI bleeding. This is not a safe or appropriate recommendation.

A. "What were you doing when the pain started?" B. "How long has the pain lasted?" C. "How would you describe the pain?" D. "How has the pain affected your relationship with your spouse?" E. "Can you rate the pain on a 0-10 scale with 10 being the worst?"

Correct Answer is ["A","B","C","E"]

Explanation

A. "What were you doing when the pain started?" This question helps identify potential triggers or activities that may have precipitated the chest pain, which is crucial for understanding the context of the pain.

B. "How long has the pain lasted?" Knowing the duration of the pain is vital in assessing the urgency of the situation and determining whether it may be related to a serious condition like angina or myocardial infarction.

C. "How would you describe the pain?" This question allows the client to characterize the pain (e.g., sharp, dull, squeezing), which can provide insights into the potential causes and the nature of the chest pain.

D. "How has the pain affected your relationship with your spouse?" While this question might provide some psychosocial context, it is less directly related to the immediate assessment of the chest pain itself and can be considered secondary.

E. "Can you rate the pain on a 0-10 scale with 10 being the worst?" Pain rating is essential in assessing the severity of the pain, which can help guide treatment and interventions.

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The nurse is caring for a client who has been taking aspirin 81mg PO daily for the last six months. Which clinical findings are of most concern? (SELECT ALL THAT APPLY)

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Naxlex Comprehensive Predictor Exams

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?

Correct Answer is B

Explanation

The nurse is performing an admission assessment of a client complaining of chest pain. Which question(s) should the nurse ask in the assessment regarding the chief complaint? (SELECT ALL THAT APPLY)

Correct Answer is ["A","B","C","E"]

Explanation

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