When providing preoperative teaching, which of the following prescribed medications should the nurse instruct the patient to discontinue before surgery?

Choice A reason: Digoxin, used for heart failure or arrhythmias, is generally continued before surgery unless contraindicated, as it maintains cardiac stability. Discontinuing it risks worsening heart function, causing arrhythmias or heart failure exacerbation, especially in patients with underlying cardiac conditions, making it inappropriate to stop preoperatively. Choice B reason: Furosemide, a diuretic for heart failure or edema, is often continued preoperatively to manage fluid overload, unless significant hypovolemia or electrolyte imbalances exist. Stopping it risks fluid retention, exacerbating cardiac or pulmonary strain, making it less critical to discontinue compared to medications affecting bleeding risk. Choice C reason: Ibuprofen, an NSAID, inhibits platelet function by blocking cyclooxygenase, increasing bleeding risk during surgery. Discontinuing it (typically 7–10 days prior) prevents excessive intraoperative or postoperative hemorrhage, as platelets are essential for hemostasis, making this the medication to stop to ensure surgical safety. Choice D reason: Metformin is often stopped 24–48 hours before surgery due to lactic acidosis risk, particularly with contrast dye or renal impairment. However, ibuprofen’s bleeding risk is a more immediate surgical concern, as it directly affects hemostasis, making it the priority medication to discontinue preoperatively.