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

Answer and Explanation

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.

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Correct Answer is A

Explanation

A. LMWHs produce a more stable effect on coagulation; thus, fewer lab tests are needed: Correct LMWHs have a more predictable anticoagulant response compared to unfractionated heparin, resulting in a more stable effect on coagulation. Because of their predictable response, routine monitoring of coagulation parameters, such as activated partial thromboplastin time (aPTT), is typically not required with LMWH therapy, unlike with unfractionated heparin.

B. LMWHs may be given by the oral route: Incorrect. LMWHs are administered by the subcutaneous route.

C. LMWHs have a short duration of action: Incorrect. LMWHs have a longer duration of action compared to unfractionated heparin.

D. LMWHs possess greater anticoagulant activity: incorrect. LMWHs generally have less potent anticoagulant activity compared to unfractionated heparin, but their more predictable response and longer half-life make them advantageous in many clinical scenario

Correct Answer is ["6.0"]

Explanation

To find the volume of amoxicillin solution the nurse needs to administer, we can divide the desired dose (300 mg) by the concentration of the solution (250 mg/5 mL).

Here's the calculation:

Amoxicillin volume (mL) = Desired dose (mg) / Concentration (mg/mL) Amoxicillin volume (mL) = 300 mg / 250 mg/5 mL

Since we're dividing by a fraction, it's mathematically equivalent to multiply by the reciprocal of the fraction. The reciprocal of 250 mg/5 mL is 5 mL/250 mg.

Amoxicillin volume (mL) = 300 mg * (5 mL / 250 mg)

Cancel out the milligrams (mg) units:

Amoxicillin volume (mL) = 300 mg / 250 mg * 5 mL

Amoxicillin volume (mL) = 1.2 mL (rounded to one decimal place)

However, since we are dealing with medication, it's best to round to the nearest whole number for accuracy in administering the dose.

Therefore, the nurse should administer 6.0 mL of amoxicillin oral solution.

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Naxlex Comprehensive Predictor Exams

What is the primary advantage of using low molecular weight heparins (LMWHs) over heparin?

Correct Answer is A

Explanation

A nurse is preparing to administer amoxicillin 300 mg PO. The amount available is amoxicillin oral solution 250 mg/5 mL. How many mL should the nurse administer? (Round the answer to the nearest tenth/whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["6.0"]

Explanation

Which of the following clump and adhere to the wall of the injured blood vessel to begin the process of hemostasis?

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