A client has a prescription for clopidogrel bisulfate 75 mg by mouth daily at 0900. In which situation should the nurse hold this medication?

Elective surgery is scheduled in two hours.

An abdominal sonogram is scheduled.

Breakfast has not been eaten.

The client's platelet level is high.

Answer and Explanation

The Correct Answer is A

A. Elective surgery is scheduled in two hours: Clopidogrel is an antiplatelet agent that significantly increases the risk of bleeding. It should be held prior to surgery to minimize intraoperative and postoperative bleeding risks. Surgeons often require clopidogrel to be discontinued several days in advance, making it critical to withhold the drug if surgery is imminent.

B. An abdominal sonogram is scheduled: An abdominal ultrasound is a noninvasive imaging test that does not carry bleeding risks. There is no need to hold clopidogrel prior to sonogram procedures because it does not impact the safety or accuracy of the imaging study.

C. Breakfast has not been eaten: Clopidogrel can be taken with or without food. Skipping a meal does not contraindicate administering the medication, although taking it with food can sometimes help reduce gastrointestinal discomfort.

D. The client's platelet level is high: Clopidogrel works by inhibiting platelet aggregation, not by lowering platelet count. A high platelet count alone is not a reason to withhold the medication unless there is a specific bleeding risk or another contraindication identified by the healthcare provider.

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Free Nursing Study Resources

Correct Answer is {"A":{"answers":"B"},"B":{"answers":"C"},"C":{"answers":"B"},"D":{"answers":"C"},"E":{"answers":"C"},"F":{"answers":"A"},"G":{"answers":"B"}}

Explanation

Therapeutic Result:

Semifluid stool

Non-therapeutic Side Effect:

Non-blanchable red area
Sinus tachycardia
Burning sensation

Unrelated Finding:

Pain rating 2 on pain scale of 0 to 10
Itching in legs
Blood pressure 135/81 mm Hg

Rationale:

Non-blanchable red area: A non-blanchable red area indicates localized skin damage and early pressure injury. It likely results from immobility and pressure near the buttock area, especially in a client on strict bedrest, rather than an effect of bisacodyl.
Pain rating 2 on pain scale of 0 to 10: The lower pain rating reflects effective pain management after receiving analgesics. It is a measure of comfort but not directly influenced by the administration of bisacodyl, which targets bowel function.
Sinus tachycardia: Sinus tachycardia can occur due to pain, stress, mild dehydration from increased bowel activity, or systemic response to immobility. It is not a typical response to bisacodyl use and requires further clinical monitoring.
Itching in legs: Itching is most likely related to nerve irritation, healing wounds, or dry skin from immobility rather than gastrointestinal effects. Bisacodyl does not commonly cause peripheral itching.
Blood pressure 135/81 mm Hg: Blood pressure is within a stable range and reflects the client’s cardiovascular status. It is not directly connected to bisacodyl administration or its gastrointestinal actions.
Semifluid stool: The semifluid stool is the intended therapeutic effect of bisacodyl, which stimulates peristalsis to promote bowel movement. This outcome shows the medication worked appropriately for constipation management.
Burning sensation: The burning sensation around the anus is a known side effect of rectal bisacodyl administration. Local irritation of the rectal mucosa can occur after suppository use, especially with frequent bowel movements.

A. Print an electrocardiogram strip B. Call for rapid response C. Perform chest compressions D. Apply oxygen via nasal cannula E. Give naloxone 2 mg intravenous push F. Provide rescue breaths with a manual ventilation bag

Correct Answer is ["B","E","F"]

Explanation

A. Print an electrocardiogram strip: While cardiac monitoring is important, printing an ECG strip does not immediately address the critical issue of respiratory depression and unresponsiveness. Priority actions must focus on airway and breathing first.

B. Call for rapid response: The client is critically unstable with severe respiratory depression and unresponsiveness, meeting criteria for a rapid response or even a code blue if the situation deteriorates further. Immediate expert team support is crucial.

C. Perform chest compressions: Chest compressions are only indicated if the client is pulseless. In this case, the client has a heart rate of 92 beats/minute, meaning compressions are not appropriate at this moment.

D. Apply oxygen via nasal cannula: A nasal cannula would not deliver high enough oxygen concentrations for someone with a respiratory rate of 5 breaths/minute and oxygen saturation of 54%. Higher oxygen delivery methods and ventilatory support are urgently needed.

E. Give naloxone 2 mg intravenous push: Naloxone is indicated immediately to reverse opioid-induced respiratory depression. Giving the prescribed naloxone IV push can rapidly counteract the morphine overdose and improve the client’s respiratory effort.

F. Provide rescue breaths with a manual ventilation bag: Because the client’s respirations are critically low, rescue breathing with a manual resuscitation bag is necessary to maintain oxygenation and ventilation until naloxone takes effect or more advanced airway management is available.

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A client has a prescription for clopidogrel bisulfate 75 mg by mouth daily at 0900. In which situation should the nurse hold this medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Patient Data Review H and P, nurse's notes, flow sheet, and prescriptions. Click to mark whether the assessment finding represents a therapeutic result of the bisacodyl administered, a non-therapeutic side effect, or an unrelated finding. Each row must have one option selected.

Correct Answer is {"A":{"answers":"B"},"B":{"answers":"C"},"C":{"answers":"B"},"D":{"answers":"C"},"E":{"answers":"C"},"F":{"answers":"A"},"G":{"answers":"B"}}

Explanation

Patient Data Which should the nurse do immediately? Select all that apply.

Correct Answer is ["B","E","F"]

Explanation

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