Clopidrogrel, more commonly known as Plavix, is an antiplatelet that suppresses platelet aggregation in arterial circulation. In simpler terms, Plavix prevents blood clots after a recent heart attack by making the blood less sticky and less likely to form together. Just knowing this, you’re able to answer this NCLEX question:
A client with a recent history of transient ischemic attack has been put on clopidrogel (Plavix). The desired therapeutic effects of this drug would be:
Now without even looking at the choices, you already know in your mind that the desired therapeutic effects would be to prevent blood clots because that is what an antiplatelet does. If you saw a choice that states that the desired therapeutic effect would be a clot-dissolving effect, you would know that this is incorrect. Plavix is NOT a thrombolytic, which dissolves existing blood clots. Without giving the wrong choices, you already know in your heart that the answer is to reduce the risk of a stroke from a blood clot.
Plavix is considered to be a secondary prevention of myocardial infarction and ischemic stroke. It would make complete sense for the client to be given Plavix after experiencing a transient ischemic attack to prevent recurring attacks.
As a nurse, it is ESSENTIAL to know when to look at a doctor’s order and question it. If a client has active bleeding, you would question the order of giving Plavix. By giving Plavix to a client with active bleeding, you would increase the bleed and cause further damage to the client. This is why nurse advocacy is so important!
When you give Plavix to a client, watch out for the side effects! Plavix can cause abdominal pain, dyspepsia (indigestion), diarrhea, and rash. The most important side effect to watch out for is BLEEDING.
A client with stomach ulcer has been given Plavix. Should you question this order? YES! You already know that stomach ulcer causes bleeding and abdominal pain. This order should be questioned because Plavix is contraindicated with clients that have an active bleeding condition!
NURSING IMPLICATION
You know by now that Plavix can cause abdominal pain. It makes sense to not give it on an empty stomach so make sure to administer with food to reduce an upset stomach. The client must be given patient education to report any signs of bleeding or bruising. Be aware of any scheduled surgery so you can discuss with the doctor to withhold the medication prior to surgery.
HT: Mosby’s Pharmacology Memory NoteCards: Visual, Mnemonic, and Memory Aids for Nurses, 4e
