Report ringing in the ears, dizziness, or confusion, which can signal salicylate toxicity.
Before you read
Test yourself first: 5 questions
Question 1 of 5
A child with Kawasaki disease is receiving intravenous immunoglobulin (IVIG) and high-dose aspirin. The nurse explains that aspirin is used in this disease to:
Answer: A. In Kawasaki disease, aspirin is used for its anti-inflammatory effect during the acute phase and its antiplatelet effect to reduce the risk of coronary thrombosis. This is one of the few pediatric indications for aspirin.
Question 2 of 5
A client taking aspirin for secondary prevention of myocardial infarction asks the nurse how low-dose aspirin protects the heart. The best response is that aspirin:
Answer: A. Low-dose aspirin irreversibly inhibits cyclooxygenase (COX-1) in platelets, blocking thromboxane A2 production and reducing platelet aggregation for the life of the platelet. It does not thin the blood by adding fluid, lower blood pressure, or dissolve existing plaque.
Question 3 of 5
A client experiencing an acute myocardial infarction is given aspirin 162 to 325 mg to chew. What is the primary purpose of this intervention?
Answer: B. Aspirin is chewed during a suspected MI to achieve rapid antiplatelet action that inhibits thromboxane-mediated platelet aggregation, limiting clot growth in the coronary artery. It is not given primarily for fever, pain relief, or as an anticoagulant that dissolves existing clots.
Question 4 of 5
A client with PAD is prescribed cilostazol. The nurse teaches that the main purpose of this medication is to do what?
Answer: A. Cilostazol is a phosphodiesterase inhibitor with antiplatelet and vasodilating effects used to reduce intermittent claudication symptoms and improve walking distance in PAD. It is not an anticoagulant for DVT, does not dissolve existing clots, and is not used to raise blood pressure.
Question 5 of 5
A client taking dabigatran for atrial fibrillation asks how the medication works. Which response by the nurse is accurate?
Answer: B. Dabigatran is a direct thrombin (factor IIa) inhibitor that blocks the conversion of fibrinogen to fibrin, preventing clot formation. It does not act on vitamin K, does not require routine INR monitoring, and is not an antiplatelet agent.
Keep the streak going with more questions like these, each with a full rationale.
What is aspirin (antiplatelet)?
It is used to prevent and treat myocardial infarction and ischemic stroke and is given (often chewed) during suspected acute coronary syndrome. Bleeding and GI irritation are the main concerns.
Key points to remember
- Irreversibly inhibits platelet COX, so antiplatelet effect lasts the lifespan of the platelet (7-10 days).
- Chewable non-enteric aspirin is given early in suspected myocardial infarction for faster effect.
- Causes GI irritation, bleeding, and dyspepsia; enteric-coated forms reduce stomach upset.
- Tinnitus and hearing changes are early signs of aspirin (salicylate) toxicity.
- Avoided in children and teens with viral illness due to risk of Reye syndrome.
- Increases bleeding risk when combined with anticoagulants, other antiplatelets, and NSAIDs.
Signs & symptoms
- GI upset, bleeding, bruising
- Tinnitus = early toxicity sign
Nursing priorities
- Assess for bleeding: bruising, GI bleeding, dark stools, and prolonged bleeding.
- For suspected MI, have the patient chew a non-enteric aspirin promptly.
- Take with food or a full glass of water to reduce gastric irritation.
- Ask about tinnitus, which can indicate toxicity, and hold for active bleeding.
Patient teaching
- Take aspirin with food or a full glass of water to protect your stomach.
- Report ringing in the ears, black stools, or unusual bleeding or bruising.
- Do not give aspirin to children or teenagers with a fever or flu-like illness.
- Tell providers and dentists you take aspirin before any procedure or surgery.
- Avoid combining with other NSAIDs or blood thinners unless approved by your provider.
Red flags: report now
- Report ringing in the ears, dizziness, or confusion, which can signal salicylate toxicity.
- Report black tarry stools, vomiting blood, or other signs of GI bleeding.
- Never give to children or teens with fever or viral illness because of Reye syndrome risk.
- Hold and report signs of an allergic reaction or active bleeding.
References
Clinical references for this topic
