A patient is scheduled for abdominal surgery tomorrow. While gathering preoperative data, the nurse learns that the patient takes the following medications daily:

Question

an anticoagulant, a multivitamin, and vitamin E. The patient reports that he stopped taking the anticoagulant 4 days ago as instructed by the surgeon. He has continued to take the multivitamin and vitamin E. Based on the information given, the nurse notifies the surgeon because she:
a. Needs an order to restart the anticoagulant
b. Is concerned about continued use of the multivitamin
c. Is concerned about the vitamin E
d. Has canceled the surgery so more lab tests can be done.

Answer 1

C
Both prescribed and over-the-counter medications may increase surgical risk. Many herbs can cause potassium loss and increase the risk for cardiac arrhythmias. Vitamin E may increase the risk for bleeding. This patient's use of vitamin E daily should be discontinued 2 weeks prior to surgery, so the nurse should inform the surgeon of the vitamin E intake. Generally, the surgeon or anesthesiologist instructs patients to continue or discontinue taking their prescribed medicines. However, it is important to assess use of supplements and over-the-counter medicines. The nurse cannot cancel surgery without an order from the surgeon, who determines whether the surgery should be delayed or whether it is so urgent that it needs to continue as scheduled, even with the additional risk factor of the vitamin E intake.