A client with atrial fibrillation has been prescribed dabigatran.
What instruction should the nurse include in this client’s teaching plan?

Eliminate spinach and other green vegetables from the diet.

Avoid the use of nonsteroidal anti-inflammatory drugs (NSAIDs).

Continue to obtain scheduled laboratory bleeding tests.

Keep an antidote available in case of hemorrhage.

Answer and Explanation

The Correct Answer is B

Choice A rationale

Eliminating spinach and other green vegetables from the diet is not necessary for a client taking dabigatran. Unlike warfarin, another anticoagulant that interacts with vitamin K found

in green leafy vegetables, dabigatran does not have this interaction. Therefore, clients taking dabigatran do not need to modify their intake of green vegetables.

Choice B rationale

The nurse should instruct the client to avoid the use of nonsteroidal anti-inflammatory drugs (NSAIDs) while taking dabigatran. NSAIDs can increase the risk of bleeding, which is already elevated in clients taking anticoagulants like dabigatran.

Choice C rationale

Continuing to obtain scheduled laboratory bleeding tests is not necessary for a client taking dabigatran. Unlike some other anticoagulants, dabigatran does not require regular blood tests to monitor its effectiveness or adjust its dosage.

Choice D rationale

Keeping an antidote available in case of hemorrhage is not typically part of the teaching plan for a client taking dabigatran. While an antidote for dabigatran does exist, it is usually administered in a hospital setting in the event of life-threatening bleeding or emergency surgery.

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Correct Answer is C

Explanation

Choice A rationale

While nausea and diarrhea can occur when using ginkgo biloba, these side effects are not the most important information for the nurse to include in the teaching plan for this client. These are common side effects that can occur with many medications and supplements, and while they should be mentioned, they are not the most critical concern with ginkgo biloba use.

Choice B rationale

The statement that ginkgo biloba use should be limited and not taken during pregnancy is important, but it is not the most critical information for this client. While ginkgo biloba should be used with caution during pregnancy, this information may not be relevant to this particular client unless she is pregnant or planning to become pregnant.

Choice C rationale

The interaction of ginkgo biloba with aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) is the most important information for the nurse to include in the teaching plan for this client. Ginkgo biloba can increase the risk of bleeding, especially when taken with other medications that affect blood clotting, such as aspirin and NSAIDs. This could lead to serious health complications for the client.

Choice D rationale

While anxiety and headaches can increase with the use of ginkgo biloba, these side effects are not the most important information for the nurse to include in the teaching plan for this client.

These are common side effects that can occur with many medications and supplements, and while they should be mentioned, they are not the most critical concern with ginkgo biloba use.

A. Serum potassium level of 3.8 mEq/L (3.8 mmol/L) B. Hemoglobin level of 13.5 g/dL (135 g/L). C. Serum glucose level of 120 mg/dL (6.7 mmol/L) D. Serum ammonia level of 30 Mcg/dL (17.62 Mermol/L)

Correct Answer is A

Explanation

Choice A rationale

Sodium polystyrene sulfonate is a medication used to treat high levels of potassium in the blood, a condition known as hyperkalemia. Hyperkalemia is a common complication of acute kidney injury (AKI). The medication works by exchanging sodium ions for potassium ions in the intestine, which are then excreted from the body. Therefore, a decrease in serum potassium levels to within the normal range (3.5-5.0 mEq/L) would indicate that the medication has been effective.

Choice B rationale

Hemoglobin levels are not directly affected by sodium polystyrene sulfonate. Hemoglobin is a protein in red blood cells that carries oxygen. While it’s an important indicator of overall health, changes in hemoglobin levels would not indicate whether treatment for hyperkalemia is working.

Choice C rationale

Sodium polystyrene sulfonate does not directly affect glucose levels. While it’s important to monitor glucose levels in patients with kidney disease, changes in glucose would not indicate whether treatment for hyperkalemia is working.

Choice D rationale

Sodium polystyrene sulfonate does not directly affect ammonia levels. While elevated ammonia levels can occur in certain conditions, such as liver disease, changes in ammonia levels would not indicate whether treatment for hyperkalemia is working.

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A client with atrial fibrillation has been prescribed dabigatran.
What instruction should the nurse include in this client’s teaching plan?