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 C

Explanation

A. Hypothermia: Clopidogrel is not typically associated with temperature regulation and wouldn't cause hypothermia.

B. Hypotension: While some medications can cause low blood pressure (hypotension), clopidogrel is not a common culprit.

C. Black stools: This can be a sign of upper gastrointestinal bleeding, which is a potential side effect of clopidogrel. Clopidogrel inhibits platelet aggregation, which can increase bleeding risk.

D. Constipation: Constipation is not a common side effect of clopidogrel.

A. Most CAM therapies are totally ineffective B. Patient must be warned the most CAM therapies for dangerous C. Additional treatment may not be needed D. CAM therapies could interact with prescription and OTC medications

Correct Answer is D

Explanation

A. Most CAM therapies are not totally ineffective: While some CAM therapies may lack strong scientific evidence, it's not accurate to say they are all ineffective. Some CAM therapies may have benefits, but it's important to be aware of them to avoid interactions.

B. Not all CAM therapies are dangerous: Many CAM therapies are generally safe. However, some can interact with medications or have unforeseen side effects, so assessing use is crucial.

C. Additional treatment may still be needed: Even if a patient uses CAM, they might still require conventional medical treatment. Assessing CAM use helps ensure a complete picture of the patient's healthcare regimen.

D. CAM therapies could interact with prescription and OTC medications. Correct. The primary reason to assess CAM use is to identify potential interactions with medications, potentially improving patient safety and treatment effectiveness.

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Naxlex Comprehensive Predictor Exams

A nurse is collecting data from a client who is receiving clopidogrel following the placement of a cardiac stent. Which of the following findings should the nurse identify as an adverse effect of this medication?

Correct Answer is C

Explanation

It is important for the nurse to assess for the use of complementary and alternative medicine (CAM) because:

Correct Answer is D

Explanation

It is important that nurses ensure that their patients receive education regarding herbal products because:

A client is taking aspirin (ASA) and asks the nurse how long the anticoagulant effect of a single dose of aspirin can last. The nurse replies:

is the stopping of blood flow, an essential mechanism protecting the body from both external and internal injury.

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

Which of the following is administered to increase the number of circulating red blood cells?

A nurse is reviewing laboratory data from a client who has pulmonary embolism and is receiving IV heparin. Which of the following findings should the nurse report to the provider?

The patient is to be started on warfarin (Coumadin) therapy. It is important for the nurse to check for the use of which herbs? (Select All that Apply.)

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.)