The nurse is doing discharge teaching with a client who has coronary artery disease.

The client asks why he has to take an aspirin every day if he doesn’t have any pain.

What would be the nurse’s best response?

Choice A rationale:

Clopidogrel is an antiplatelet medication that is essential for preventing blood clots from forming within coronary artery stents. It works by inhibiting the binding of adenosine diphosphate (ADP) to its receptors on platelets, thereby reducing platelet aggregation. This is crucial following stent placement because the stent itself can act as a trigger for platelet activation and clotting. By suppressing platelet function, clopidogrel helps to maintain blood flow through the stented artery and reduces the risk of stent thrombosis, a potentially life-threatening complication.

Here's a detailed explanation of why the other choices are incorrect:

Choice B: Ibuprofen

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that is primarily used to treat pain and inflammation.

It does not have significant antiplatelet effects and is not typically used for the prevention of stent thrombosis.

While it might be prescribed for pain management after stent placement, it would not be the primary medication expected on the daily medication administration record for this purpose.

Choice C: Dipyridamole

Dipyridamole is an antiplatelet medication, but it is not as potent as clopidogrel and is not considered the first-line agent for preventing stent thrombosis.

It might be used in combination with clopidogrel in certain cases, but it would not be the sole antiplatelet medication expected on the daily medication administration record.

Choice D: Acetaminophen

Acetaminophen is a pain reliever and fever reducer.

It does not have any antiplatelet effects and would not be used to prevent stent thrombosis.

It might be prescribed for pain or fever after stent placement, but it would not be the primary medication expected on the daily medication administration record for this purpose.

Choice A rationale:

Ventricular Fibrillation (VF) is a chaotic, disorganized rhythm that arises from the ventricles of the heart. It is characterized by the absence of distinct QRS complexes, P waves, and T waves on the ECG. Instead, the ECG shows a rapid, irregular pattern of waveforms that vary in amplitude and frequency. This indicates that the electrical activity in the ventricles is completely disorganized, preventing effective contraction of the heart muscle and leading to a lack of cardiac output. VF is a lifethreatening emergency that requires immediate defibrillation to restore a normal heart rhythm.

Key features of VF on ECG:

Absence of distinct QRS complexes

Absence of P waves

Absence of T waves

Rapid, irregular pattern of waveforms Varying amplitude and frequency of waveforms Pathophysiology of VF:

VF occurs when multiple ectopic foci in the ventricles fire rapidly and asynchronously, leading to disorganized electrical activity. This can be caused by a variety of factors, including:

Acute myocardial infarction (heart attack)

Myocardial ischemia (reduced blood flow to the heart muscle)

Electrolyte imbalances (such as low potassium or magnesium)

Electrical shock

Certain medications

Drug overdoses

Clinical manifestations of VF:

Loss of consciousness

Absence of pulse

Apnea (absence of breathing)

Cardiac arrest

Treatment of VF:

Immediate defibrillation

CPR

Advanced cardiac life support (ACLS) medications Choice B rationale:

Atrial Flutter is a rapid, regular atrial rhythm that is characterized by a sawtooth pattern on the ECG. It is caused by a reentrant circuit in the atria, which leads to a rapid firing of atrial impulses. Atrial flutter can sometimes be difficult to distinguish from VF on ECG, but it is important to differentiate between the two rhythms because the treatment is different.

Choice C rationale:

Ventricular Tachycardia (VT) is a rapid, regular ventricular rhythm that is characterized by wide QRS complexes on the ECG. It is caused by an abnormal focus of electrical activity in the ventricles. VT can be life-threatening, but it is not as immediately life-threatening as VF.

Choice D rationale:

Asystole is the absence of any electrical activity in the heart. It is a form of cardiac arrest and is characterized by a flat line on the ECG. Asystole is a life-threatening emergency that requires immediate CPR and advanced cardiac life support (ACLS) measures.