The nurse understands that a client who has had a bone marrow aspiration to assist in the diagnosis of aplastic anemia requires additional teaching when they state:
I can have aspirin 650 mg for pain when the procedure is over.
The nurse will check the puncture site at least every 4 hours after the procedure.
I will have some pain that is similar to a toothache.
I understand that this is a sterile procedure.
The Correct Answer is A
Choice A reason: The client requires additional teaching if they state that they can have aspirin for pain after the bone marrow aspiration. Aspirin is a drug that inhibits platelet aggregation and increases the risk of bleeding. ¹ The client should avoid aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) for at least 48 hours after the procedure. ² The client should use acetaminophen or another pain reliever that does not affect blood clotting.
Choice B reason: The client does not require additional teaching if they state that the nurse will check the puncture site at least every 4 hours after the procedure. This is a correct statement, as the nurse should monitor the site for signs of bleeding, infection, or hematoma. ² The nurse should also apply pressure and a sterile dressing to the site and instruct the client to keep it dry and clean for 24 hours.
Choice C reason: The client does not require additional teaching if they state that they will have some pain that is similar to a toothache. This is a correct statement, as the client may experience mild to moderate pain at the site of the aspiration, which may radiate to the hip or back. ² The pain usually subsides within a few hours or days.
Choice D reason: The client does not require additional teaching if they state that they understand that this is a sterile procedure. This is a correct statement, as the bone marrow aspiration is performed under sterile conditions to prevent infection. ² The nurse should wear gloves, gown, mask, and eye protection and use a sterile needle, syringe, and antiseptic solution.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
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
Correct Answer is B
Explanation
Choice A reason: Increasing the intake of dietary fiber is not related to the instruction for carvedilol. Dietary fiber is beneficial for lowering cholesterol and blood sugar levels, but it does not affect the action or side effects of carvedilol. The client should follow a balanced diet that is low in sodium, fat, and cholesterol.
Choice B reason: This is the correct answer. Changing from a lying to sitting position slowly is an important instruction for carvedilol. Carvedilol is a beta-blocker that lowers the blood pressure and the heart rate. It can cause orthostatic hypotension, which is a sudden drop in blood pressure when changing positions. This can lead to dizziness, fainting, or falls. The client should change positions gradually and avoid sudden movements.
Choice C reason: Expecting weight gain of 6-8 pounds is not an instruction for carvedilol. Weight gain is not a common or expected side effect of carvedilol. It can indicate fluid retention, which can worsen the heart condition and the blood pressure. The client should monitor their weight regularly and report any significant changes to the health care provider.
Choice D reason: Taking the medication after eating breakfast is not an instruction for carvedilol. Carvedilol can be taken with or without food, depending on the client's preference and tolerance. The important thing is to take the medication at the same time every day and not to skip or double the doses.
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