A nurse's friend says, I may have to have some dental work done ...

[hbsimmons88]

A nurse's friend says, I may have to have some dental work done and I am concerned because I take aspirin every day. How should the nurse respond to this information?
 
  Standard Text: Select all that apply.
  1. When you go to the dentist, be sure to report your aspirin use.
  2. Since you take such a small dose of aspirin, there is no problem.
  3. The usual recommendation is to stop taking aspirin a week before any dental or surgical procedure.
  4. Aspirin therapy is not associated with bleeding from dental procedures.
  5. Any bleeding from your procedure can be reversed by taking vitamin E.

Question 2

A person being seen at a health fair says, I hurt my foot running last week and have been taking aspirin for the pain. Is that okay? Which questions should the nurse ask before answering this question?
 
  A person being seen at a health fair says, I hurt my foot running last week and have been taking aspirin for the pain. Is that okay? Which questions should the nurse ask before answering this question?

[Mochi]

Answer to Question 1

Correct Answer: 1,3
Rationale 1: The dentist should be made aware that the client takes aspirin daily.
Rationale 2: Doses as small as 75 mg/day can increase the risk of bleeding.
Rationale 3: The usual recommendation is to discontinue use of aspirin a week prior to any dental or surgical procedure.
Rationale 4: Aspirin therapy can cause bleeding from dental procedures.
Rationale 5: Vitamin E does not reverse bleeding.
Global Rationale: The antiplatelet effects of aspirin can promote bleeding at sites other than the GI tract even in doses as small as 75 mg/day. Because it irreversibly inhibits COX-1 in platelets, the antiplatelet action of aspirin can be prolonged. It may take longer for minor cuts and injuries to stop bleeding. Patients undergoing surgical or dental procedures should discontinue aspirin use a week prior to the procedure. Vitamin E does not reverse bleeding.

Answer to Question 2

Correct Answer: 1,2,4
Rationale 1: The risk of gastrointestinal bleeding is greater in people over age 60.
Rationale 2: The risk of gastrointestinal bleeding is greater in people who smoke.
Rationale 3: Taking vitamin C is neither a recommendation nor a contraindication for use of aspirin.
Rationale 4: Clients with gastric ulcer disease have a higher risk of gastrointestinal bleeding while taking aspirin.
Rationale 5: Being of Hispanic heritage has no impact on whether aspirin therapy is safe.
Global Rationale: The most significant adverse effect of aspirin and other NSAIDs is GI bleeding. Although the risk is dose related, even low doses of aspirin (75325 mg/day) may double the risk of GI bleeding. Risk factors for aspirin-induced GI bleeding include history of peptic ulcers, age greater than 60, use of anticoagulants or corticosteroids, Helicobacter pylori infection, smoking, and use of alcohol. Use of vitamin C and being of Hispanic heritage are not significant determinants in the use of NSAIDs.

[hbsimmons88]

TYSM

[xiaomengxian]

Excellent