The healthcare provider determines that an older client, who takes daily aspirin, is at risk for a stroke. Which finding causes the nurse to contact the healthcare provider?
1. The client has a previously undisclosed distant history of myocardial infarction.
2. The client reports stools are occurring more frequently and are darker than normal.
3. Ferrous sulfate is on the client's home medication list but is not currently prescribed.
4. Low-molecular-weight heparin therapy is prescribed by a different healthcare provider.
2. The client reports stools are occurring more frequently and are darker than normal.
Explanation: 1. This is not urgent and can be added to the chart and mentioned to the provider later. No need to specifically contact the provider if the client isn't having MI symptoms. Aspirin irreversibly inhibits platelet aggregation by blocking enzymes in the clotting process and impairing prostaglandin metabolism. Aspirin is used for primary and secondary prevention of myocardial infarction and stroke.
2. Blood in the stool causes irritation that causes it to move more quickly through the intestines and can result in a tarry or black and sticky appearance.
3. The nurse can mention this prescription to the provider when they make rounds on the client. There is no need for a notification to restart an iron supplement.
4. Enoxaparin or other LMWH are prescribed sometimes with aspirin. This should be addressed to ensure both providers know the client is on these medications, but it is not uncommon and does not require specifically contacting the provider. Low-molecular-weight heparin therapy is prophylactic therapy for DVT in older adults who have had surgery, a myocardial infarction, or major joint replacement surgery.
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a. Ask the daughter about the patient's food preferences. b. Determine who shops for groceries and prepares the meals. c. Question the patient about how many meals per day are eaten. d. Assure the patient that culturally preferred foods will be included.
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