Understanding Chronic Illnesses
Understanding Chronic Illnesses ( 4 Questions)
A client with rheumatoid arthritis (RA) is scheduled for a joint replacement surgery. The nurse should teach the client to discontinue which medication before the surgery to prevent bleeding complications?
This is an incorrect option, as prednisone is a corticosteroid that is used to suppress inflammation and immune responses in clients with RA. Prednisone does not affect bleeding time or platelet function. However, prednisone can increase the risk of infection and delay wound healing, so it should be tapered gradually before the surgery to avoid adrenal insufficiency and withdrawal symptoms.
This is an incorrect option, as methotrexate is a disease-modifying antirheumatic drug (DMARD) that is used to slow down the progression of joint damage and reduce inflammation in clients with RA. Methotrexate does not affect bleeding time or platelet function. However, methotrexate can increase the risk of infection and bone marrow suppression, so it should be discontinued at least 2 weeks before the surgery.
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that is commonly used to treat pain and inflammation in clients with RA. However, NSAIDs can also inhibit platelet aggregation and prolong bleeding time, increasing the risk of hemorrhage during and after surgery. Therefore, ibuprofen should be discontinued at least 7 days before the surgery.
This is an incorrect option, as hydroxychloroquine is an antimalarial drug that is used to treat mild to moderate RA. Hydroxychloroquine does not affect bleeding time or platelet function. However, hydroxychloroquine can cause ocular toxicity, so it should be monitored regularly by an ophthalmologist.
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that is commonly used to treat pain and inflammation in clients with RA. However, NSAIDs can also inhibit platelet aggregation and prolong bleeding time, increasing the risk of hemorrhage during and after surgery. Therefore, ibuprofen should be discontinued at least 7 days before the surgery.
Incorrect options:
A) Prednisone - This is an incorrect option, as prednisone is a corticosteroid that is used to suppress inflammation and immune responses in clients with RA. Prednisone does not affect bleeding time or platelet function. However, prednisone can increase the risk of infection and delay wound healing, so it should be tapered gradually before the surgery to avoid adrenal insufficiency and withdrawal symptoms.
B) Methotrexate - This is an incorrect option, as methotrexate is a disease-modifying antirheumatic drug (DMARD) that is used to slow down the progression of joint damage and reduce inflammation in clients with RA. Methotrexate does not affect bleeding time or platelet function. However, methotrexate can increase the risk of infection and bone marrow suppression, so it should be discontinued at least 2 weeks before the surgery.
D) Hydroxychloroquine - This is an incorrect option, as hydroxychloroquine is an antimalarial drug that is used to treat mild to moderate RA. Hydroxychloroquine does not affect bleeding time or platelet function. However, hydroxychloroquine can cause ocular toxicity, so it should be monitored regularly by an ophthalmologist.