The healthcare provider prescribes clopidogrel (Plavix) for a patient at risk for a myocardial infarction. While instructing the patient about the adverse effects and precautions associated with this drug, the nurse tells him that the following drugs should not be used while on clopidogrel unless the doctor is consulted. (Select all that apply.)
alteplase (Activase)
Diltiazem
Ibuprofen
Aspirin
Coumadin
Correct Answer : A,B,C,D,E
A. Alteplase (Activase): Alteplase is a thrombolytic agent used to dissolve blood clots. Concurrent use with clopidogrel, an antiplatelet medication, can increase the risk of bleeding due to additive effects on clotting. Therefore, it's important to consult the doctor before using these medications together.
B. Diltiazem: Diltiazem is a calcium channel blocker used to treat hypertension and certain heart rhythm disorders. Diltiazem will decrease the level or effect of clopidogrel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Therefore, it's advisable to consult the doctor before using these medications together.
C. Ibuprofen: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) used to relieve pain and inflammation. Like other NSAIDs, it can increase the risk of bleeding when taken with clopidogrel. Therefore, it's important to consult the doctor before using these medications together.
D. Aspirin: Aspirin is another antiplatelet medication commonly used to prevent heart attacks and strokes. Combining clopidogrel with aspirin can increase the risk of bleeding without significantly improving outcomes in most cases. However, in some situations, such as after certain cardiac procedures, dual antiplatelet therapy (clopidogrel plus aspirin) may be prescribed under close medical supervision. Therefore, it's crucial to consult the doctor before using these medications together.
E. Coumadin (warfarin): Coumadin is an anticoagulant medication used to prevent blood clots. Concurrent use with clopidogrel can increase the risk of bleeding. Therefore, it's essential to consult the doctor before using these medications together.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Use a 22-gauge needle to inject the medication.
This is inappropriate. Subcutaneous injections typically require a smaller gauge needle, usually between 25 to 30 gauge, to minimize tissue damage and discomfort. A 22-gauge needle is too large for subcutaneous injections and is more appropriate for intramuscular injections.
B. Inject the medication into the abdomen above the level of the iliac crest.
This is appropriate. The preferred site for subcutaneous heparin injection is the abdomen, avoiding areas near the umbilicus by at least 2 inches. Injecting above the level of the iliac crest is appropriate as it ensures the medication is administered into the subcutaneous tissue where it can be properly absorbed. The abdomen is chosen due to its ample subcutaneous tissue and relatively few large blood vessels, reducing the risk of bleeding and bruising.
C. Massage the injection site after administration of the medication.
This is inappropriate. Massaging the injection site after administering heparin is not recommended as it can cause bruising and increase the risk of bleeding. Heparin is an anticoagulant, and massaging the site can disrupt the tissue and lead to complications.
D. Use a 1-inch needle to inject the medication.
This is inappropriate. A 1-inch needle is generally used for intramuscular injections, not subcutaneous injections. For subcutaneous injections, a shorter needle (usually 3/8 to 5/8 inch) is sufficient to reach the subcutaneous tissue without penetrating too deeply into muscle tissue.
Correct Answer is ["A","B","C","D"]
Explanation
A. Prayer: Prayer and meditation are practices that focus on the mind-body connection and can be used for relaxation, stress reduction, and promoting inner peace. These practices are often included in CAM approaches.
B. Yoga: Yoga combines physical postures, breathing exercises, and meditation. It can improve flexibility, strength, balance, and overall well-being, making it a popular CAM therapy.
C. Massage: Massage therapy involves manipulating the soft tissues of the body to promote relaxation, pain relief, and improved circulation. It's a widely used CAM therapy.
D. Meditation: Meditation involves focusing your attention and quieting the mind. It can promote relaxation, reduce stress, and improve emotional well-being, aligning with CAM principles.
E. Ointments with a steroid base: Steroid creams are medications typically prescribed by doctors for specific skin conditions. While some natural remedies might be used topically in CAM, ointments with a steroid base wouldn't be considered a CAM therapy itself.
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