Chapter 14: Nonopioid Analgesics: Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) and Migraine Headache Medications Introductory Clinical Pharmacology 12th Edition by Susan M Ford

Introductory Clinical Pharmacology 12th Edition by Susan M Ford 1. A nurse is performing discharge teaching for a client who is prescribed ibuprofen. After teaching the client about the possible cardiovascular effects of the drug, the nurse determines that additional teaching is needed when the client states which comment? a. “My blood pressure may increase.” b. “My blood pressure won't change.” c. “I could develop congestive heart failure.” d. “I could experience a heart attack.” Answer: B Rationale: The client should be counseled that NSAIDs including ibuprofen may result in the following cardiovascular effects: increased or decreased blood pressure, congestive heart failure, cardiac arrhythmias, and myocardial infarction. Question Format: Multiple Choice Chapter: 14 Learning Objective: 7 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Teaching/Learning Reference: p. 177, Cardiovascular System Reactions 2. A nurse is preparing a presentation for a local community group about over-the-counter analgesics, including NSAIDs. Which possible reaction would the nurse integrate into the presentation as a serious risk with this class of drugs? a. Increased granulocyte count b. Cardiovascular thrombosis c. Increased WBC count d. Sickle cell anemia Answer: B Rationale: A serious risk involved with the use of NSAIDs is cardiovascular thrombosis. Increased granulocyte count, increased WBC count, or sickle cell anemia is not caused by NSAIDs. Sickle cell anemia results from an inherited abnormality of hemoglobin. NSAIDs may cause decreased granulocyte count, decreased WBC count, or aplastic anemia. Question Format: Multiple Choice Chapter: 14 Learning Objective: 4 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Teaching/Learning Reference: p. 184, Key Points 3. A nurse is assessing the medical record of a client with arthritis who is to receive Celecoxib. The nurse would question this order based on which finding in the client's history? a. Allergy to sulfonamides b. Diabetic retinopathy c. Cataract d. Acute gout Answer: A Rationale: Celecoxib is contraindicated among clients with allergy to sulfonamides. Ethambutol is contraindicated in clients with diabetic retinopathy and clients with cataracts. Pyrazinamide is contraindicated among clients with acute gout. Question Format: Multiple Choice Chapter: 14 Learning Objective: 5 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 177, Contraindications 4. A nurse is providing care to a client with arthritis in several large weight-bearing joints who is receiving NSAID therapy. Which nursing diagnosis would be most appropriate? a. Risk for Unstable Blood Glucose Levels b. Impaired Gas Exchange c. Risk for Imbalanced Body Temperature d. Impaired Physical Mobility Answer: D Rationale: The client has arthritis and is receiving NSAID therapy most likely for pain relief and reduction of inflammation. The affected joints would interfere with the client's mobility. Therefore, Impaired Physical Mobility would be most appropriate. There is no indication that the client has diabetes, respiratory problems, or fever. Therefore, the other nursing diagnoses would be inappropriate. Question Format: Multiple Choice Chapter: 14 Learning Objective: 6 Cognitive Level: Analyze Client Needs: Physiological Integrity: Physiological Adaptation Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 183, Impaired Physical Mobility 5. A nurse is preparing a discharge teaching for a client who is to continue taking NSAIDs at home. Which important point should the nurse prioritize in the teaching? a. Take aspirin if necessary strictly with a full glass of water. b. Use the drug on a very regular basis during treatment. c. Call your health care provider if you have no relief after 2 weeks. d. Take the drugs strictly with a glass of milk or juice. Answer: C Rationale: The nurse should instruct the client to consult the primary health care provider if the pain, swelling, inflammation, or tenderness is not relieved after 2 weeks. The drug takes several days to relieve the discomfort, so it is important for the client to give the drug time to work. The nurse should instruct the client to avoid the use of aspirin. The drug should be taken with a full glass of water or with food. It is not necessary to take NSAIDs strictly with a glass of juice or milk. These drugs are not to be used on a regular basis unless the client is strictly instructed to do so by the primary health care provider. Question Format: Multiple Choice Chapter: 14 Learning Objective: 7 Cognitive Level: Apply Client Needs: Physiological Integrity: Reduction of Risk Potential Integrated Process: Teaching/Learning Reference: p. 183, Educating the Client and Family 6. A nurse caring for a client who is receiving an NSAID for fever reduction documents a decrease in urinary output for the client. Which event would the nurse most likely determine as the reason for the client's condition?