A nurse is reviewing a client's medication list during a routine clinic visit. The nurse notices that the client is taking warfarin and aspirin daily. Which of the following actions should the nurse take?

Ask the client if they have any signs of bleeding, such as bruising, gum bleeding, or black stools.

Instruct the client to stop taking aspirin immediately and notify their prescriber.

Document the medication list as obtained and proceed with the visit.

Contact the prescriber to clarify the indication and dosage of both medications.

Answer and Explanation

The Correct Answer is D

A) Incorrect. Asking the client about signs of bleeding is important, but not sufficient. The nurse should also address the potential drug-drug interaction between warfarin and aspirin, which can increase the risk of bleeding complications.

B) Incorrect. Instructing the client to stop taking aspirin without consulting the prescriber is inappropriate and potentially harmful. The client may have a valid reason for taking both medications, such as atrial fibrillation and coronary artery disease.

C) Incorrect. Documenting the medication list without further investigation is negligent and unsafe. The nurse has a responsibility to ensure that the medications are appropriate and reconciled with the prescriber.

D) Correct. Contacting the prescriber to clarify the indication and dosage of both medications is the best action. The nurse should verify that the prescriber is aware of the combination and that the benefits outweigh the risks. The nurse should also confirm that the client is receiving regular monitoring of their international normalized ratio (INR).

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Correct Answer is B

Explanation

A) Incorrect. Informing the client that these supplements are not effective and should be discontinued is disrespectful and inaccurate. These supplements may have some benefits for certain conditions, such as cognitive function, cardiovascular health, and inflammation. The nurse should respect the client's preferences and beliefs, as long as they do not pose a significant risk to their health.

B) Correct. Documenting the supplements on the medication list and notifying the surgical team is the best action. These supplements may have antiplatelet or anticoagulant effects, which can increase the risk of bleeding during or after surgery. The surgical team may advise the client to stop taking these supplements before the surgery, depending on their individual risk factors and type of surgery.

C) Incorrect. Instructing the client to stop taking these supplements at least 2 weeks before the surgery is premature and outside the scope of practice of the nurse. The nurse should consult with the surgical team before making any recommendations about discontinuing any medications or supplements.

D) Incorrect. Ignoring the supplements as they are not relevant to the surgical procedure is irresponsible and unsafe. The nurse should consider all medications and supplements that the client is taking, as they may have an impact on their perioperative care and outcomes.

A. The client's verbal report of their medications and doses. B. The client's medication list from their primary care provider. C. The client's medication bottles brought from home. D. The client's electronic health record from another facility.

Correct Answer is C

Explanation

C) Correct. The client's medication bottles brought from home are the most reliable source of information for obtaining an accurate medication history, as they contain the name, dose, frequency, and expiration date of each medication. The bottles can also be used to verify the client's verbal report and other sources of information.

A) Incorrect. The client's verbal report of their medications and doses may not be accurate, as the client may forget, omit, or confuse some medications or doses. The verbal report should be confirmed with other sources of information, such as medication bottles or lists.

B) Incorrect. The client's medication list from their primary care provider may not be up to date, as the client may have changed, discontinued, or added some medications since their last visit. The medication list should be compared with other sources of information, such as medication bottles or verbal report.

D) Incorrect. The client's electronic health record from another facility may not reflect the current medications that the client is taking, as the facility may have different policies, protocols, or formularies than the admitting hospital. The electronic health record should be supplemented with other sources of information, such as medication bottles or lists.

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A nurse is reviewing a client's medication list during a routine clinic visit. The nurse notices that the client is taking warfarin and aspirin daily. Which of the following actions should the nurse take?

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A nurse is reviewing a client's medication list during a routine clinic visit. The nurse notices that the client is taking warfarin and aspirin daily. Which of the following actions should the nurse take?