The nurse reinforces teaching a client on prescribed dabigatran for chronic atrial fibrillation. which statement by the client indicates a need for further teaching? 1. "i will call my health care provider if i notice red urine or blood in my stool." 2. "i will not stop taking dabigatran even if i get a stomachache." 3. "i will place capsules in my pill box so i will not forget to take a dose." 4. "i will swallow the capsule whole with a full glass of water."

3. I will place capsules in my pill box so I will not forget to take a dose.

Explanation - Dabigatran is a drug that has anticoagulant property and helps in dissolving blood clots thereby reducing the risk of cardiac stroke if the person is suffering from chronic atrial fibrillation.

In this case, the nurse should ensure to create awareness to the client about taking precautions of bleeding such as using a toothbrush that has soft-bristle, using an electric razor to shave. Dabigatran capsules are supposed to be kept in their authentic box or blister pack until the time of use to prevent its contamination by the moisture.

    however, coronary heart disease , or chd, is actually a result of coronary artery disease, or cad, said edward a. fisher, m.d., ph.d., m.p.h., an american heart association volunteer who is the leon h. charney professor of cardiovascular medicine and also of the marc and ruti bell vascular biology and disease program at the nyu school of medicine.

  with coronary artery disease, plaque first grows within the walls of the coronary arteries until the blood flow to the heart’s muscle is limited. view an illustration of coronary arteries. this is also called ischemia. it may be chronic, narrowing of the coronary artery over time and limiting of the blood supply to part of the muscle. or it can be acute, resulting from a sudden rupture of a plaque and formation of a thrombus or blood clot.

    the traditional risk factors for coronary artery disease are high ldl cholesterol, low hdl cholesterol, high blood pressure, family history, diabetes, smoking, being post-menopausal for women and being older than 45 for men, according to fisher. obesity may also be a risk factor.

    “coronary artery disease begins in childhood, so that by the teenage years, there is evidence that plaques that will stay with us for life are formed in most people,” said fisher, who is former editor of the american heart association journal, atvb. “preventive measures instituted early are thought to have greater lifetime benefits. healthy lifestyles will delay the progression of cad, and there is hope that cad can be regressed before it causes chd.”

  living a healthy lifestyle that incorporates good nutrition, weight management and getting plenty of physical activity can play a big role in avoiding cad.

    “coronary artery disease is preventable,” agreed johnny lee, m.d., president of new york heart associates, and an american heart association volunteer. “typical warning signs are chest pain, shortness of breath, palpitations and even fatigue.” if you feel any of these symptoms, don’t delay — call 9-1-1.