Contraindications: Excessive Bleeding – NSAIDs (Nursing)

00:00 Okay, so that's renal compromise. Let's look at the risk of excessive bleeding.

00:05 Now before we go on, I bet you could already nail this.

00:09 I bet you could already tell me why there's a risk of excessive bleeding.

00:13 So pause the video and jot down as many notes as you can before we go on.

00:18 Use as many big names that we've discussed as you can then join us again.

00:27 Okay, welcome back. So for -- because of the risk of excessive bleeding, you know, with a COX inhibitor, I have less, what substance? Thromboxane. Good, that's really good.

00:41 So that puts me at an increased risk of excessive bleeding cuz we know thromboxane helps us make thrombosis which are clots.

00:49 So you can understand why most health care providers will recommend stopping all NSAIDs one week before elective surgery cuz they wanna decrease that risk of bleeding with surgery.

01:00 So that means prescription NSAIDs and over-the-counter. All NSAIDs.

01:05 Now we shouldn't have a problem with the 81 mg low dose aspirin but anything bigger than that, stronger than that, we'll likely ask the patient to be off for one week to have that all filtered through the system.

01:18 Now, we talked about aspirin, ibuprofen, naproxen, and most all of prescription NSAIDs for one week.

01:26 You wanna make sure that the patient doesn't take those.

01:29 So how does the patient know not to do that? Well, if you've ever gone in for procedure, they give you like all these directions and paperwork and signing things and you're working with your insurance and it's very overwhelming.

01:42 So it often takes a nurse, an excellent nurse, who's willing to make eye contact with their patient and make sure the patient understands.

01:51 So using teach back is a great way to do that.

01:54 Okay, I know Mr. Taylor, we've given you lots of directions, right? And how that -- can you tell me what the most important things are about the medications that you're currently taking that we need you to stop a week before surgery? If they can speak that back to you, then you have a pretty good feel for what they know.

02:12 But be calm, be patient, and be thorough.

02:16 You do this every day but patients, it's not something they have occur every day.

02:23 It's not a daily activity for them so be patient with them and double check these things that could make such a significant difference on their kidneys or on their bleeding after post-op.

02:33 It's your job to make sure they're very clear on what should be done.