A nurse is preparing to administer digoxin 0.25 mg PO to a client. The amount available is digoxin 0.125 mg tablets. How many tablets should the nurse administer to the client?

(Round to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

A. Reduced cardiac output: While liver disease can affect circulation in later stages, abnormal coagulation is a more immediate concern.

B. Abnormal coagulation: The liver plays a vital role in producing proteins essential for blood clotting. Liver damage can impair this function, leading to increased bleeding risk.

C. Electrolyte imbalance: The liver plays a role in some aspects of electrolyte balance, but abnormal coagulation is a more specific and critical complication in early liver damage.

D. Respiratory issues: While liver disease can progress to respiratory complications in severe cases, abnormal coagulation is a more immediate threat.

A. "The anticoagulant effect of a single dose of aspirin can last for as long as a month." This statement is incorrect. While aspirin has antiplatelet effects that inhibit blood clot formation, its duration of action is not as long as a month. Aspirin irreversibly inhibits the enzyme cyclooxygenase (COX), thereby inhibiting platelet aggregation. However, the effects on platelet function are not permanent, and platelets turnover within a few days, thus the anticoagulant effect of a single dose of aspirin typically lasts for a shorter duration.

B. "The anticoagulant effect of a single dose of aspirin can last for as long as a day." Aspirin's primary effect is on platelets, not directly on overall blood clotting. It inhibits the COX enzyme, reducing the production of thromboxane A2, a chemical that promotes platelet aggregation. The initial inhibition of platelet function is strongest within the first 24 hours after taking aspirin. However, the affected platelets remain dysfunctional for their entire lifespan (around 7-10 days).

C. "The anticoagulant effect of a single dose of aspirin can last for as long as a week." This statement is correct. Aspirin's effect on platelets is due to its irreversible inhibition of the COX enzyme. Platelets have a lifespan of about 7-10 days. Once a platelet is affected by aspirin, it cannot regain its function. As your body continuously produces new platelets, the overall antiplatelet effect gradually diminishes over time.

D. "The anticoagulant effect of a single dose of aspirin can last for as long as 12 hours."

Rationale: This statement is partially correct. The antiplatelet effect of aspirin does not typically last as short as 12 hours. While the peak inhibition of platelet function occurs within hours after administration, the duration of action is longer due to the irreversible inhibition of COX-1. However, stating that it lasts exactly 12 hours may not be entirely accurate for all individuals, as the duration of action can vary depending on factors such as individual metabolism and dose.