Nokea
A nurse is describing the actions of NSAIDs to a client. Which of the following would the nurse integrate into the description as a mechanism by which NSAIDs elicit their effects? Select all that apply.
- A. Inhibition of prostaglandins
- B. Inhibition of cyclooxygenase-1
- C. Synthesis of cyclooxygenase-2
- D. Synthesis of cyclooxygenase-3
- E. Inhibition of platelet aggregation
Correct Answer: A,B,C
Rationale: NSAIDs exert their effects by inhibition of prostaglandin synthesis via inhibition of cyclooxygenase-1 and -2.
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After teaching a client about his prescribed NSAID therapy, the nurse determines that the teaching was successful when the client states which of the following?
- A. I will take the drug with high-fiber foods.
- B. I must take the drug on an empty stomach.
- C. I should take the drug with food and milk.
- D. I need to take it with a calcium supplement.
Correct Answer: C
Rationale: The client should take the drug with food and milk to promote an optimal response to NSAID therapy, this helps minimize the risk of GI effects. The client does not need to take an NSAID with fiber-rich food or with calcium supplements. He should not take it on an empty stomach.
Prior to administering an NSAID to a client, the nurse should obtain which of the following? Select all that apply.
- A. History of allergies
- B. Pain assessment
- C. Current medical conditions
- D. Past medical conditions
- E. Vital signs
Correct Answer: A,B,C,D,E
Rationale: Before administering an NSAID, the nurse should obtain a history of allergies and past medical conditions. Other preadministration assessment includes pain, current medical conditions and vital signs.
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 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 likely?
- A. Risk for Unstable Blood Glucose Levels
- B. Impaired Gas Exchange
- C. Risk for Imbalanced Body Temperature
- D. Impaired Physical Mobility
Correct 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.
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.