A patient has begun taking an HMG-COA reductase inhibitor (statins). Which statement about this class of drugs made by the nurse during patient education would be inappropriate?

Choice A reason: The option that the patient "cannot be treated" is incorrect because Pneumocystis carinii pneumonia (PCP) in HIV-positive patients can be treated with medications such as trimethoprim-sulfamethoxazole (TMP-SMX). There are also preventive measures and treatments available for individuals with HIV/AIDS to manage PCP and improve their health outcomes. Thus, this option is not accurate for the scenario described.
Choice B reason: The diagnosis of Pneumocystis carinii pneumonia (PCP) in an HIV-positive patient strongly indicates that the patient has progressed to AIDS. AIDS, or acquired immunodeficiency syndrome, is diagnosed when an individual with HIV develops certain opportunistic infections or their CD4 cell count drops below a critical level. PCP is one of the most common opportunistic infections seen in AIDS patients, signifying severe immune system compromise due to the advanced stage of HIV infection. This makes option B the correct answer.
Choice C reason: The option stating that the patient "has less than 2 years to live" is incorrect because it is not a definitive prognosis for patients with PCP or AIDS. With appropriate medical treatment and adherence to antiretroviral therapy (ART), HIV-positive individuals, even those diagnosed with AIDS, can live longer and healthier lives. Advances in medical care have significantly improved the life expectancy and quality of life for people living with HIV/AIDS. Therefore, this option is not accurate for this scenario.
Choice D reason: The option that the patient "was an intravenous drug user" is incorrect because PCP can affect any HIV-positive individual, regardless of their drug use history. While intravenous drug use is a known risk factor for HIV transmission, it is not directly related to the development of PCP. PCP is caused by a weakened immune system due to HIV progression, not the method of HIV transmission. Thus, this option does not appropriately address the diagnosis of PCP.

Choice A reason:
Holding the heparin and notifying the provider is the appropriate action. The significant drop in platelet count suggests the possibility of heparin-induced thrombocytopenia (HIT), a serious complication of heparin therapy. Immediate discontinuation of heparin and further evaluation are necessary to manage this condition.

Choice B reason:
Requesting an order for vitamin K (phytonadione) is not appropriate in this scenario. Vitamin K is used to reverse the effects of warfarin, not heparin. The issue here is the potential for HIT, not an over-anticoagulation that requires vitamin K.

Choice C reason:
While requesting a PTT test is part of managing anticoagulation therapy, it is not the immediate priority in this case. The significant drop in platelet count is more concerning for HIT, which requires stopping heparin and notifying the provider for further evaluation.

Choice D reason:
Administering oxygen and notifying the provider is not specific to managing the issue of a significantly low platelet count in a patient on heparin. The primary concern here is the potential for HIT, which necessitates stopping the heparin.