A client taking rivaroxaban develops acute kidney injury. Classify each finding by the medication decision it supports.
Matrix
Choose your responses, then check the answer.
Explanation
Rapid renal decline and oliguria support altered rivaroxaban exposure; melena and a hemoglobin fall support active bleeding; holding nephrotoxins and urgent dose or therapy review support renal and anticoagulant safety.
Why this is correct Rivaroxaban labeling directs clinicians to consider dose adjustment or discontinuation when acute renal failure develops. Bleeding severity and the continuing thrombotic indication must be evaluated together.
Easy analogy or mental picture When the drug exit slows, exposure can rise; the stool and hemoglobin show whether harm may already be occurring.
Memory hook Kidney down plus bleeding signs means immediate anticoagulant review.
NCLEX decision rule Classify renal-change cues separately from direct bleeding evidence and protective interventions.
Why the other choices are wrong A previously acceptable dose is not automatically safe after abrupt renal deterioration.
References
1DailyMed: RivaroxabanRenal impairment, acute renal failure review, bleeding surveillance, and avoidance of unsafe exposure
DOAC renal reviewTrend creatinine clearance, urine output, last dose, interacting drugs, bleeding, hemoglobin, hemodynamics, indication, and the authorized hold or replacement plan.