Aspirin might be one of the oldest and most common medications in healthcare, but for nursing students, it’s also one of the most misunderstood. In this episode of Think Like a Nurse, creator Brooke Wallace—ICU nurse, organ transplant coordinator, and clinical instructor—breaks down why this tiny pill carries such high stakes. You’ll learn how dosing changes everything, from mild pain relief to cardiac protection, and why irreversible platelet inhibition makes aspirin a must-know for NCLEX and safe practice. We’ll cover the “stop the drug” red flags, how to recognize early toxicity, and why certain patients—like kids with viral illnesses—should never receive it. Get ready to connect the dots between textbook pharmacology and real-world nursing judgment.
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.”