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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Administering glucagon prior to meals to prevent hyperglycemia is not a recommended use of a glucagon emergency kit. Glucagon is a hormone that raises blood glucose levels by causing the liver to release stored glucose into the bloodstream. It is typically used to treat severe hypoglycemia (low blood sugar), not to prevent hyperglycemia (high blood sugar).
Choice B rationale
The nurse should instruct the client and family to administer glucagon when symptoms of severe hypoglycemia are present. Severe hypoglycemia is a potentially life-threatening condition that can cause symptoms such as confusion, blurred vision, seizures, and loss of consciousness. In such cases, glucagon can be administered to quickly raise the blood glucose level.
Choice C rationale
Administering glucagon when the client is unable to eat during sick days is not a recommended use of a glucagon emergency kit. While it’s true that illness can affect blood glucose levels,
glucagon is specifically used to treat severe hypoglycemia. Other strategies, such as adjusting insulin doses or consuming liquid or soft carbohydrates, are typically recommended when a person with diabetes is sick and unable to eat their usual meals.
Choice D rationale
Administering glucagon at the onset of symptoms of diabetic ketoacidosis is not a recommended use of a glucagon emergency kit. Diabetic ketoacidosis is a serious complication of diabetes that occurs when the body starts breaking down fat at a rate that is much too fast. The liver processes the fat into a fuel called ketones, which causes the blood to become acidic. Glucagon would not be effective in treating this condition.
Correct Answer is A
Explanation
Choice A rationale
Hypertension is a condition that should be reported to the healthcare provider before administering phenylephrine. Phenylephrine is a decongestant used to relieve nasal discomfort caused by colds, allergies, and hay fever. It works by shrinking swollen nasal mucous membranes, which relieves nasal congestion. However, it can cause a rise in blood pressure, which could be dangerous for patients with hypertension.
Choice B rationale
Bronchitis is not a contraindication for phenylephrine. However, if the patient has a chronic respiratory condition like bronchitis, it’s always a good idea to discuss any new medications with the healthcare provider.
Choice C rationale
Diarrhea is not a contraindication for phenylephrine. Phenylephrine is not known to cause or worsen diarrhea.
Choice D rationale
Edema is not a contraindication for phenylephrine. However, if the patient has a history of heart disease or high blood pressure, which can sometimes cause edema, they should inform their healthcare provider.
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