A client is 2 weeks post-drug-eluting stent placement and says, “I stopped ticagrelor yesterday because I have bruises.” Which response is the priority?
1“Restart ticagrelor only after all bruises have completely disappeared.”
2“Replace ticagrelor and aspirin with ibuprofen until the bruises improve.”
3“Continue withholding ticagrelor until the next routine cardiology visit.”
4“Contact cardiology now to assess bleeding and authorize the antiplatelet plan.”✓ Correct answer
Explanation
Early unplanned interruption of a prescribed P2Y12 inhibitor after ACS PCI can threaten stent patency; bruising and bleeding must be assessed promptly without an unsupervised stop.
Quick answer Escalate for a same-day bleeding and stent-protection plan.
Why this is correct DAPT balances ischemic protection against bleeding. The nurse should assess the bruising, identify dangerous bleeding, and obtain an authorized plan rather than endorse unilateral interruption.
Easy analogy or mental picture Do not remove a bridge support without checking whether the bridge is still carrying its highest load.
Memory hook New stent plus stopped P2Y12 inhibitor means call now.
NCLEX decision rule Treat adherence interruption as a time-sensitive medication-safety issue after recent PCI.
Why the other choices are wrong Waiting, substituting an NSAID, or using bruise resolution alone ignores both stent and bleeding risk.
References
1AHA/ACC 2025 Acute Coronary Syndromes GuidelineDAPT after ACS, individualized bleeding strategies, and coordinated secondary prevention
DAPT interruption reviewAssess last dose, stent timing, bleeding site and severity, hemoglobin, other antithrombotics, NSAIDs, adherence barrier, and cardiology instructions.