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Key Points to Know for NCLEX 

Mechanism: Irreversible COX-1 and COX-2 inhibition → decreases prostaglandin and thromboxane A2 production

Dose Dependence:

Low dose (81 mg) = cardioprotection

Moderate (325–650 mg) = pain and fever

High (3–6 g/day) = anti-inflammatory

Irreversible platelet inhibition: lasts 7–10 days (platelet lifespan)

Absolute contraindications: active ulcers, bleeding disorders, aspirin allergy, children with viral illness (Reye’s syndrome)

Toxicity warning: tinnitus = early sign of salicylism → hold dose and notify provider

Priority nursing actions: monitor for GI bleeding (black stools, epistaxis, bruising), avoid alcohol, do not crush enteric-coated tablets

Emergency use: chew 325 mg for suspected MI (AHA guideline)

Salicylate poisoning: early = tinnitus, N/V; late = hyperthermia, metabolic acidosis → treat with activated charcoal, fluids, IV sodium bicarbonate, possible dialysis

Drug interactions: ibuprofen blocks cardioprotective effect, anticoagulants ↑ bleeding risk

NCLEX connection: “Never give aspirin to children with viral illness,” “hold if bleeding or tinnitus,” “different dose = different drug.”

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