Question

a nurse in a providers office is assessing a client who has been taking aspirin daily for the past year. for which of the following findings should the nurse immediately notify the provider?

hyperventilation
heartburn
anorexia
swollen ankles

Explanation:

Analyze the clinical scenario

The client has been taking aspirin daily for a year. Aspirin is a salicylate. Chronic daily use or high doses can lead to salicylate toxicity, also known as salicylism.

Evaluate the clinical findings

• Hyperventilation: This is a key sign of acute or chronic salicylate poisoning (salicylism). Salicylates directly stimulate the respiratory center in the brainstem, causing hyperventilation, which leads to respiratory alkalosis. This is a serious finding requiring immediate medical notification.
• Heartburn: This is a common, expected gastrointestinal side effect of daily aspirin use due to local mucosal irritation and systemic prostaglandin inhibition. While uncomfortable, it does not require immediate notification unless accompanied by signs of active GI bleeding.
• Anorexia: Decreased appetite can occur with chronic aspirin use but is not an acute, life-threatening emergency.
• Swollen ankles: This is not a classic or immediate sign of aspirin toxicity.

Determine the priority action

Hyperventilation indicates a systemic toxic effect (salicylism) that can rapidly progress to severe acid-base imbalances. Therefore, the nurse must immediately notify the provider of this finding.

Answer:

• Hyperventilation (Correct answer)
• Heartburn
• Anorexia
• Swollen ankles