Question

The nurse provides care for a client scheduled for surgery the following morning. The preoperative prescriptions include NPO after midnight. No medications are prescribed to be withheld before surgery. Which medication causes the nurse to question its administration prior to surgery? (Select all that apply.)

A) Valsartan 80 mg given daily for hypertension.
B) Clonazepam 2 mg given twice daily to prevent seizures.
C) Triamterene 50 mg given every morning for hypertension.
D) Prednisone 5 mg given once daily for asthma.
E) Dabigatran 75 mg given daily for atrial fibrillation.
F) Quetiapine 50 mg given at bedtime for insomnia.

Answer 1

A nurse should question the administration of dabigatran prior to surgery due to its anticoagulant properties, which increase the risk of bleeding. The nurse and surgical team must review all medications and ensure essential protocols, such as pre-surgery antibiotics when necessary, are followed to minimize risks.

Step-by-step explanation:

The question pertains to the medications that a nurse should consider holding before a patient goes for surgery. Considering the prescriptions the client has, careful assessment needs to be made regarding the potential risks that come with continuing or discontinuing medication prior to surgery. Certain medications, especially those that affect blood clotting or blood pressure, have significant implications for surgical patients.

Factors to Consider

When preparing a patient for surgery, it is crucial that the surgical team, including the surgeon, nurse, and anesthesia professional, review aloud the key concerns for the recovery and care of the patient. This includes confirmation that prophylactic antibiotics have been administered appropriately before surgery to reduce the risk of hospital-acquired infections, ensuring that all essential imaging results are available, and assessing the suitability of ongoing medication.

Of the listed medications: valsartan and triamterene are antihypertensives, clonazepam is anti-seizure medication, prednisone is a steroid, dabigatran is an anticoagulant, and quetiapine is an antipsychotic used here for insomnia. While blood pressure medications are generally continued to avoid hypertensive episodes, there is a potential concern with anticoagulants like dabigatran because they can increase the risk of bleeding during surgery. The nurse should question the administration of dabigatran (E) due to this risk.

Critical Thinking

As for the critical thinking query, avoiding certain medications, such as allergy medications before allergy testing, is crucial because these medicines can interfere with the test results, masking symptoms that are important for accurate diagnosis.