A patient is prescribed aspirin for Coronary Artery Disease.
Which of the following should the nurse monitor?
Increased urine output.
Signs of hyponatremia.
Elevated blood glucose levels.
Signs of bleeding such as bruising or blood in stool.
The Correct Answer is D
Choice A rationale
Aspirin does not typically increase urine output. In fact, in large doses, it can cause renal impairment leading to decreased urine output. Aspirin is a non-steroidal anti-inflammatory drug (NSAID) and can be nephrotoxic, particularly with long-term use or in high doses, but it is not a diuretic.
Choice B rationale
Aspirin does not cause hyponatremia. Hyponatremia is a low sodium level in the blood (normal range 135-145 mEq/L) and is often associated with conditions like fluid overload or the use of certain diuretics. Aspirin's primary effects are on platelet aggregation and inflammation, not electrolyte balance.
Choice C rationale
Aspirin does not cause elevated blood glucose levels. Medications that typically cause hyperglycemia include corticosteroids, some diuretics, and certain antipsychotics. Aspirin's primary mechanism of action involves inhibiting cyclooxygenase enzymes, which are not directly involved in glucose metabolism.
Choice D rationale
Aspirin is an antiplatelet medication that irreversibly inhibits cyclooxygenase-1 (COX-1), preventing the formation of thromboxane A2 and subsequent platelet aggregation. This increases the risk of bleeding. The nurse must monitor for signs of hemorrhage, such as bruising, petechiae, blood in the stool (melena), or coffee-ground emesis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Furosemide is a loop diuretic used to treat edema and hypertension. It primarily works by increasing the excretion of salt and water from the body and does not have a direct role in the long-term management of cholesterol levels in patients with coronary artery disease.
Choice B rationale
Statins are the cornerstone of long-term cholesterol management in patients with coronary artery disease. They work by inhibiting HMG-CoA reductase, an enzyme essential for cholesterol synthesis in the liver, thereby lowering LDL ("bad") cholesterol and reducing the risk of cardiovascular events.
Choice C rationale
Nifedipine is a calcium channel blocker used to treat hypertension and angina. While it can improve coronary blood flow, it does not directly affect cholesterol levels and is not considered a primary medication for the long-term management of hyperlipidemia.
Choice D rationale
Clopidogrel is an antiplatelet medication that prevents blood clots. Its role is to reduce the risk of thrombosis in patients with coronary artery disease, but it has no effect on cholesterol metabolism and is not used for the management of lipid levels.
Correct Answer is B
Explanation
Choice A rationale
Renal failure is not a common or expected adverse effect of alpha-blockers. While a drop in blood pressure could theoretically impact kidney perfusion, renal failure is not the primary adverse effect that the nurse should assess for, especially when the medication is administered for the first time. The nurse should be focused on the most common and immediate side effects of the drug.
Choice B rationale
Alpha-blockers, such as prazosin or terazosin, work by blocking alpha-1 adrenergic receptors, which causes vasodilation and a decrease in peripheral vascular resistance. The most significant adverse effect upon the first dose is a profound drop in blood pressure, known as first-dose hypotension, which can lead to dizziness, syncope, and falls. The nurse must assess for this effect by monitoring blood pressure and advising the patient to change positions slowly.
Choice C rationale
Blood dyscrasias, such as neutropenia or thrombocytopenia, are not common adverse effects of alpha-blockers. These are more frequently associated with certain other drug classes like antithyroid medications or some psychiatric medications. While all medications have a risk of adverse effects, blood dyscrasias are not the primary concern for the nurse when administering an alpha-blocker for the first time.
Choice D rationale
While some medications can cause dysrhythmias, this is not the most common or immediate adverse effect to assess for with the first dose of an alpha-blocker. The primary and most direct physiological effect of these medications is vasodilation, which leads to hypotension. Dysrhythmias are a more likely side effect of other cardiovascular drugs, such as beta-blockers, not alpha-blockers.
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