When preparing a client who is to undergo a resection of a leiomyosarcoma of the uterus, the nurse notices that apixaban is listed on the medication reconciliation list. Which assessment finding requires immediate nursing intervention?

When preparing a client who is to undergo a resection of a leiomyosarcoma of the uterus, the nurse notices that apixaban is listed on the medication reconciliation list. Which assessment finding requires immediate nursing intervention?

• A. Abdominal redness and itching.
• B. Nausea and dry mouth.
• C. Bleeding gums.
• D. Finger joint pain.

Answer: (C)

Anticoagulants like apixaban slow the blood’s ability to clot, so any sign of bleeding needs immediate attention before surgery. Bleeding gums point to active bleeding or an excessive anticoagulant effect, which can lead to significant perioperative hemorrhage if not addressed right away. This finding should prompt prompt assessment of the patient’s status and communication with the surgical team to adjust anticoagulation—often including holding the DOAC and planning for monitoring or reversal as guided. The other symptoms don’t directly indicate a bleeding risk in this preoperative context: abdominal redness and itching could be a skin reaction, nausea and dry mouth are common side effects, and finger joint pain isn’t related to anticoagulation or bleeding.

Anticoagulants like apixaban slow the blood’s ability to clot, so any sign of bleeding needs immediate attention before surgery. Bleeding gums point to active bleeding or an excessive anticoagulant effect, which can lead to significant perioperative hemorrhage if not addressed right away. This finding should prompt prompt assessment of the patient’s status and communication with the surgical team to adjust anticoagulation—often including holding the DOAC and planning for monitoring or reversal as guided. The other symptoms don’t directly indicate a bleeding risk in this preoperative context: abdominal redness and itching could be a skin reaction, nausea and dry mouth are common side effects, and finger joint pain isn’t related to anticoagulation or bleeding.