Nokea
A nurse is assessing a client's pain. When reporting the assessment findings to the primary health care provider to ensure the proper prescription for analgesic therapy for effective pain management, which of the following would be most important for the nurse to report? Select all that apply.
- A. Duration
- B. Aggravating factors
- C. Location
- D. Remitting factors
- E. Intensity
Correct Answer: C,E
Rationale: Although duration, aggravating and remitting factors, location, and intensity are important to assess, to ensure that the primary health care provider prescribes effective analgesics for pain management, the nurse needs to report two key assessments about pain: location and intensity.
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A nurse would expect to administer prescribed NSAIDs as part of the treatment plan for clients with which conditions? Select all that apply.
- A. Osteoarthritis
- B. Fever
- C. Rheumatoid arthritis
- D. Severe postoperative pain
- E. Primary dysmenorrhea
Correct Answer: A,B,C,E
Rationale: NSAIDs are used to treat fever and the mild to moderate pain that may be associated with osteoarthritis, rheumatoid arthritis, and primary dysmenorrhea. Severe postoperative pain would most likely require an opioid analgesic.
A nurse is preparing a presentation for a local community group about over-the-counter analgesics, including NSAIDs. Which of the following 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
Correct 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.
A client is prescribed tolmetin to be taken at home. The nurse would instruct the client to monitor for which of the following? Select all that apply.
- A. Dark, tarry stools
- B. Jaundice
- C. Hot, dry, flushed skin
- D. Increased urine output
- E. Unusual or prolonged bleeding
Correct Answer: A,C,E
Rationale: The nurse should instruct the client or caregiver to monitor for dark, tarry stools; hot, dry, flushed skin; decreased urine output, and unusual or prolonged bleeding.
A nurse is teaching a client who is prescribed sumatriptan about the possible adverse reactions associated with the drug. The nurse determines that the teaching was successful when the client identifies which of the following as most common? Select all that apply.
- A. Flushing
- B. Bradycardia
- C. Dry mouth
- D. Impaired vision
- E. Fatigue
Correct Answer: A,C,E
Rationale: The most common adverse reactions associated with the selective serotonin agonists like sumatriptan (Imitrex) include dizziness, nausea, fatigue, pain, dry mouth, and flushing.
A 60-year-old client with rheumatoid arthritis visits the health care facility for a regular checkup. The client informs the nurse that he has been using an over-the-counter NSAID for the last few days. The nurse cautions the client about the use of NSAIDs on a long-term basis because of the increased risk for which of the following?
- A. Ulcer disease
- B. CNS disorders
- C. Hearing impairment
- D. Blindness
Correct Answer: A
Rationale: Age appears to increase the possibility of adverse reactions to NSAIDs. The risk of serious ulcer disease in adults older than 65 years is increased with higher doses of NSAIDs. CNS disorders, hearing impairment, and blindness are not effects associated with using NSAIDs on a long-term basis in older clients.