# The client is 5 days post-PCI for acute coronary syndrome. Highlight the findings that require medication follow-up before discharge.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522054&lang=en  
> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

The client is 5 days post-PCI for acute coronary syndrome. Highlight the findings that require medication follow-up before discharge.

| Domain | Finding or statement |
| --- | --- |
| Adherence | The client plans to stop ticagrelor tomorrow because bruises look concerning |
| Bleeding | Black stool began today and hemoglobin decreased from 13.2 to 10.8 g/dL |
| Nonprescription drug | The client takes ibuprofen 600 mg three times daily for knee pain |
| Duplicate therapy | A combination cold product at home also contains aspirin |
| Access site | The radial site is dry without swelling or loss of pulse |
| Secondary prevention | The prescribed high-intensity statin is listed once |
| Respiratory status | SpO2 is 97 percent on room air |
| Follow-up | Cardiology follow-up is scheduled and transportation is available |

## Explanation

Self-stopping ticagrelor, new melena with a hemoglobin decrease, routine ibuprofen use, and an unreviewed duplicate aspirin product require immediate antithrombotic medication reconciliation.

## In-depth explanation

Quick answer
Protect both stent patency and bleeding safety.

Why this is correct
DAPT reduces recurrent ischemic events after ACS but increases bleeding risk. New bleeding, nonprescribed NSAIDs, duplicate aspirin, or a plan to stop the P2Y12 inhibitor require coordinated review rather than unilateral changes.

Easy analogy or mental picture
The anti-clot bridge must stay intact, but extra bleeding weights cannot be added without review.

Memory hook
After PCI: do not self-stop, do not double aspirin, and report bleeding.

NCLEX decision rule
Identify modifiable bleeding risks while preserving the prescribed antiplatelet strategy.

Why the other choices are wrong
A stable radial site, adherence to a prescribed statin, and normal oxygenation do not require antiplatelet correction.References
1AHA/ACC 2025 Acute Coronary Syndromes GuidelineDual antiplatelet therapy after ACS, bleeding-risk mitigation, and coordinated medication decisions

## Clinical scenario

Post-PCI reconciliation
Verify each antiplatelet, aspirin source, bleeding symptom, hemoglobin trend, NSAID use, procedure plan, adherence barrier, and responsible prescriber.

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