chapter 16 anti-inflammatory pharm prepu
A patient with arthritis is on nonsteroidal anti-inflammatory drug (NSAID) therapy. What should be evaluated by the nurse to determine the effectiveness of NSAID therapy?
Better mobility
A patient with arthritis is on nonsteroidal anti-inflammatory drug (NSAID) therapy. What should be evaluated by the nurse to determine the effectiveness of NSAID therapy? Body temperature Better mobility Respiratory rate Blood sugar
Better mobility
The client has been prescribed one aspirin a day. The nurse understands that is prescribed for which of the following? To decrease temperature To treat osteoarthritis To inhibit platelet aggregation To decrease pain
To inhibit platelet aggregation
A COX-1 inhibitor has known protective effects on what organ? Select all that apply. kidneys liver ovaries heart stomach
stomach kidneys
A 49-year-old woman has been diagnosed with myalgia. The health care provider has recommended aspirin. The client is concerned that the aspirin will upset her stomach. The nurse will encourage the client to take this medication by: avoiding drinking milk for 3 hours after swallowing the tablet. swallowing the tablet whole. crushing the tablet before swallowing. swallowing the tablet with milk or foo
swallowing the tablet with milk or food.
It has been found that COX-2 inhibitors can increase the risk for cardiovascular problems because they block:
vasodilation.
A parent brings their toddler to the emergency department, telling the nurse the child has gotten into a bottle of baby aspirin. The parent estimates that there were between fifteen and twenty 81-mg tablets in the bottle, which is now empty. The nurse should anticipate what treatment? administration of naloxone as prescribed administration of syrup of ipecac watchful waiting and supportive care gastric lavage
watchful waiting and supportive care
A female client reports a mild headache and is prescribed acetaminophen 325 mg, two tablets by mouth every 4 to 6 hours. The client states that she usually takes ibuprofen for her headaches and asks why the health care provider ordered acetaminophen. Which explanation would the nurse give? "Acetaminophen is more effective than ibuprofen for headaches." "Acetaminophen is less expensive and more efficient for pain relief." "Acetaminophen will reduce the inflammation causing your headache." "Acetaminophen is often the initial drug of choice for relieving mild to moderate pain."
"Acetaminophen is often the initial drug of choice for relieving mild to moderate pain."
A client prescribed allopurinol denies any current symptoms of gout. What response should the nurse provide when the client asks why the medication has been prescribed? "Allopurinol promotes formation of uric acid. It is used in combination with another drug to prevent reoccurrences of the symptoms of gout." "Allopurinol is used to cure hyperuricemia, which commonly occurs with gout." "Allopurinol is not a first-line drug but can be used to cure gout." "Allopurinol is used to prevent or treat hyperuricemia, which commonly occurs with gout."
"Allopurinol is used to prevent or treat hyperuricemia, which commonly occurs with gout."
Which instruction would be most important to include when teaching parents about over-the-counter (OTC) anti-inflammatory agents? "Make sure to give the drug on an empty stomach or before meals." "Be sure to read the label for the ingredients and dosage." "Refrain from using acetaminophen for the child's symptoms." "Aspirin is best for treating your child's flulike symptoms."
"Be sure to read the label for the ingredients and dosage."
The client states that he knows many people who take acetaminophen, and asks the nurse what it is used for. What is the best response by the nurse? "It is used to treat severe arthritis." "It is used to treat chronic pain." "It is an aspirin substitute for pain and fever." "It is an anti-inflammatory medication."
"It is an aspirin substitute for pain and fever."
After teaching a local community group about the use of OTC anti-inflammatory agents, the nurse determines that the group needs additional teaching when they state: "These drugs are relatively safe since they don't have adverse effects." "We can easily overdose on them if we don't follow the directions." "Other signs and symptoms of an illness might not appear with these drugs." "The drugs might interact with other drugs and cause problems."
"These drugs are relatively safe since they don't have adverse effects."
A client is alarmed to be prescribed celecoxib (Celebrex), stating, "I heard on TV that Celebrex causes heart attacks." How should the nurse best respond? "That was a scare that was entirely created by the media." "This drug hasn't been definitively proven to be unsafe, so it's still available." "As long as you take your heart medications, you'll be fine." "A final decision from the FDA on whether Celebrex is safe will be released in 2018."
"This drug hasn't been definitively proven to be unsafe, so it's still available."
The nurse has conducted a health education session for new parents. After learning about the safe and effective use of anti-inflammatories, which statement by the parents indicates effective teaching? "We need to give the drug on an empty stomach or two hours after meals." "We should use aspirin if our child develops symptoms of the flu." "We can temporarily give our child extra doses of acetaminophen if we need to do so." "We need to read the labels carefully for the ingredients and dosages."
"We need to read the labels carefully for the ingredients and dosages."
A male client is taking aspirin 81 mg by mouth each day for prevention of recurrent myocardial infarction. He makes a dentist appointment for a tooth extraction. He calls the health care provider's office and asks the nurse if he is at risk for bleeding. Which response is correct? "No, the dose of aspirin is too low to increase your risk of bleeding." "Your dentist must extract the tooth in a hospital setting to reduce the risk of hemorrhage." "Yes, low doses of aspirin may increase your risk of bleeding; I will call you with your new prescriber's orders." "Yes, you need to stop the aspirin immediately."
"Yes, low doses of aspirin may increase your risk of bleeding; I will call you with your new prescriber's orders."
The nurse is teaching the client, who has been newly prescribed etanercept, how to administer the medication. What statement is accurate? "Inject this medication deeply into the muscle to promote absorption." "Do not take this medication for at least 1 hour after taking an antacid." "Be sure to drink a whole glass of water when swallowing the pill." "You can rotate subcutaneous injection sites to avoid tissue damage."
"You can rotate subcutaneous injection sites to avoid tissue damage."
A client began taking acetylsalicylic acid several years ago to prevent platelet aggregation following a myocardial infarction. Which dose of aspirin is the client most likely taking daily? 180 mg 81 mg 650 mg 325 mg
81 mg
Which client is at highest risk for developing hepatotoxicity related to the use of acetaminophen? A female 50 years of age with hypoprothrombinemia A male 30 years of age who drinks four beers per day A female 62 years of age with a vitamin K deficiency A male 40 years of age with arthritis
A male 30 years of age who drinks four beers per day
A parent has sought care from the nurse practitioner to treat a child's fever. The nurse practitioner is most likely to recommend what nonsalicylate drug? Acetaminophen Ibuprofen Indomethacin Naproxen
Acetaminophen
A client with acute joint inflammation tells the nurse , "I've been taking acetaminophen as it's ordered on the bottle, but my swelling and inflammation doesn't seem to be getting better." What should the nurse teach the client? Acetaminophen has no effect on inflammation." It takes some people a few weeks to feel a difference." "Acetaminophen's only clinical use is for pain treatment." "Keep taking it as ordered, and watch for any signs of bleeding."
Acetaminophen has no effect on inflammation."
A child has symptoms of influenza, including a fever. Which medication should not be administered to the child because of the risk of Reye's syndrome? Acetaminophen Ibuprofen Ascorbic acid Acetylsalicylic acid
Acetylsalicylic acid
Which properties do salicylate analgesics and acetaminophen share? (Select all that apply.) Analgesic Inhibition of prostaglandins Anti-inflammatory Antipyretic Inhibition of platelet aggregation
Analgesic Antipyretic
What effects are exerted by aspirin? (Select all that apply.) Antipyretic Analgesic Anti-inflammatory Anti-infective Antiviral
Analgesic Antipyretic Anti-inflammatory
What should a nurse recognize as a property of ibuprofen/Motrin? (Select all that apply.) Anti-inflammatory Analgesic Antipruritic Antipyretic Antibacterial
Anti-inflammatory Analgesic Antipyretic
A male 16 years of age presents to the health care provider's office with nausea, vomiting, and pain in the right upper quadrant. He states he has had flu-like symptoms for four to five days. What is the most appropriate action of the nurse? Ask if he has been around anyone with hepatitis. Ask how much alcohol he drinks. Ask for a medication history. Ask if he has been exposed to anyone with a fungal infection.
Ask for a medication history.
A male patient has been prescribed methotrexate. The nurse should caution the patient against using which over-the-counter medication? Aspirin Acetaminophen Milk of magnesia Calcium carbonate
Aspirin
Which drug is used to decrease the risk of myocardial infarction in patients with unstable angina or previous myocardial infarction? Salsalate Aspirin Diflunisal Magnesium salicylate
Aspirin
The nurse is discussing ethnic differences in response to medication with nursing students. What group of people would the nurse tell the students have a decreased sensitivity to pain-relieving effects of anti-inflammatory drugs and should be educated concerning signs and symptoms of gastrointestinal bleeding from use of these drugs? White Americans Hispanic Americans Asians Americans Black Americans
Black Americans
A student nurse asks the nurse why acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) help to reduce cancer pain. What is the nurse's best explanation? -Cancer often produces chronic pain from tumor invasion of tissues or complications of treatment. These drugs prevent sensitization of peripheral pain receptors by inhibiting prostaglandin formation. -Cancer rarely produces severe pain from tumor invasion of tissues or complications of treatment. These drugs prevent sensitization of peripheral pain receptors by inhibiting prostaglandin formation. -Cancer often produces chronic pain from tumor invasion of tissues or complications of treatment. These drugs potentiate sensitization of peripheral pain receptors by increasing prostaglandin formation. -Cancer rarely produces chronic pain from tumor invasion of tissues or complications of treatment. These drugs eliminate sensitization of peripheral pain receptors by inhibiting prostaglandin formation.
Cancer often produces chronic pain from tumor invasion of tissues or complications of treatment. These drugs prevent sensitization of peripheral pain receptors by inhibiting prostaglandin formation.
The nurse is caring for a client with gout that is taking colchicine. In addition to the administration of this medication, what education can the nurse provide to help with the prevention of future episodes of gout? For an acute gouty flare up take double the dose and then another dose in 1 hour Severe diarrhea is an expected response Follow a low purine diet Alcohol can be used in moderation only
Follow a low purine diet
An 80-year-old male client presents to the health care provider's office with reports of fatigue and a change in the color of stools. He self-administers ibuprofen 400 mg each night for general discomfort. The provider orders a stool test for guaiac, which yields positive results. The provider discontinues the ibuprofen. The nurse is responsible for a client education plan. The client should be educated regarding what as a risk with chronic use of NSAIDs? GI distress GI upset GI bleed GI discomfort
GI bleed
An 80-year-old male client presents to the health care provider's office with reports of fatigue and a change in the color of stools. He self-administers ibuprofen 400 mg each night for general discomfort. The provider orders a stool test for guaiac, which yields positive results. The provider discontinues the ibuprofen. The nurse is responsible for a client education plan. The client should be educated regarding what as a risk with chronic use of NSAIDs? GI upset GI discomfort GI distress GI bleed
GI bleed
A client is admitted to the emergency department with a suspected overdose of acetaminophen. What adverse effect is the most common in acute or chronic overdose of acetaminophen? Pancreatitis Pulmonary insufficiency Nephrotoxicity Hepatotoxicity
Hepatotoxicity
A salicylate is contraindicated in clients who have had surgery within the past week for which reason? Increased risk for bleeding Increased risk for fluid imbalance Increased risk for toxicity Increased risk for allergic reaction
Increased risk for bleeding
What best describes the action of nonsteroidal anti-inflammatory drugs (NSAIDs)? Act directly on thermoregulatory cells Inhibit phagocytosis Inhibit prostaglandin synthesis Blocks hypothalamus activity
Inhibit prostaglandin synthesis Nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit prostaglandin synthesis. Salicylates block prostaglandin activity. Acetaminophen acts directly on thermoregulatory cells in the hypothalamus. Gold salts inhibit phagocytosis.
What information should be provided to a client diagnosed with an acetylsalicylic acid allergy? It is safe to use only buffered forms of acetylsalicylic acid. Nonsteroidal anti-inflammatory drugs (NSAIDs) should be taken for only short periods of time. Nonsteroidal anti-inflammatory drugs (NSAIDs) should always be taken with food. Nonaspirin form of nonsteroidal anti-inflammatory drugs (NSAIDs) should be avoided.
Nonaspirin form of nonsteroidal anti-inflammatory drugs (NSAIDs) should be avoided.
An 8-year-old child is experiencing pain following tonsillectomy. Which drug would be an appropriate pain reliever for this client? Morphine Barbiturates Salicylates Nonsalicylates
Nonsalicylates
Which diffuse connective tissue disease is the result of an autoimmune reaction that results in phagocytosis, producing enzymes within the joint that break down collagen and cause edema? Rheumatoid arthritis (RA) Systemic lupus erythematosus Polymyositis Osteoporosis
Rheumatoid arthritis (RA)
A 15-year-old client is brought to the emergency department by his friends. He reports visual changes, drowsiness, and tinnitus. He is confused and hyperventilating. These symptoms may be attributable to which condition? Caffeine abuse Acute acetaminophen poisoning Ibuprofen overdose Salicylate intoxication
Salicylate intoxication
The nurse would question the health care provider who prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) for which client? The client diagnosed with psoriasis The client diagnosed with peptic ulcers The client diagnosed with diabetes The postpartum woman who had a vaginal birth
The client diagnosed with peptic ulcers
A client has developed a fever. What aspect of the client's health history would contraindicate the safe and effective use of acetaminophen? The client's most recent hospital admission was because seizures which were treated with benzodiazepines The client was prescribed diclofenac for back pain and did not experience pain relief The client has hepatitis C and abuses alcohol The client had an allergic reaction to penicillin during a previous admission
The client has hepatitis C and abuses alcohol
A client is prescribed acetaminophen to reduce an elevated body temperature. Which instruction should the nurse give to the client regarding the drug's use? Inform the client to take NSAIDs if pain increases. Urge the client to refrain from drinking alcohol. Ask the client to avoid taking calcium supplements. Instruct the client to eat foods that are rich in salicylates.
Urge the client to refrain from drinking alcohol.
A group of nursing students are reviewing information about nonopioid analgesics. The students demonstrate understanding of the information when they identify which drug as a nonsalicylate analgesic? diflunisal acetaminophen magnesium salicylate aspirin
acetaminophen
A woman who is in the second trimester of her first pregnancy has been experiencing frequent headaches and has sought advice from her nurse practitioner about safe treatment options. What analgesic can the nurse most safely recommend? Acetaminophen Aspirin Ibuprofen Diflunisal (Dolobid)
acetaminophen
A nurse is assigned to care for a patient with arthritis in a health care facility. The patient has been prescribed celecoxib. Celecoxib is contraindicated in clients with: allergy to sulfonamides. diabetic retinopathy. acute gout. cataract.
allergy to sulfonamides.
The nurse correctly identifies which medications used to in the treatment of pain? analgesics. bronchodilators. cephalosporins. ACE inhibitors.
analgesics
A nurse is aware that a client prescribed meloxicam is most likely being treated for what health problem? arthritis fever a chronic wound migraine
arthritis
How should a nurse best explain the presence of the inflammation process? as the initial stage of infection, requiring antibiotic medication for resolution as a normal response to infection or trauma, which results in necrotic tissue formation as an attempt by the body to remove the damaging agent and repair the damaged tissue as a typical response to bacterial infection
as an attempt by the body to remove the damaging agent and repair the damaged tissue
How should a nurse best explain the presence of the inflammation process? as a normal response to infection or trauma, which results in necrotic tissue formation as the initial stage of infection, requiring antibiotic medication for resolution as a typical response to bacterial infection as an attempt by the body to remove the damaging agent and repair the damaged tissue
as an attempt by the body to remove the damaging agent and repair the damaged tissue Inflammation is the normal body response to tissue damage from any source, and it may occur in any tissue or organ. The remaining options are either incorrect or incomplete descriptions of the inflammation process.
A nurse is reviewing the medical record of a client who is prescribed nonsteroidal anti-inflammatory drug (NSAID) therapy. The nurse determines that the drug would be contraindicated for the client if a hypersensitivity to which drug was found? aspirin hydrochlorothiazide acetaminophen lisinopril
aspirin
Prior to administering NSAIDs, the nurse asks the client about an allergy to: analgesics. aspirin. antibiotics. acetaminophen.
aspirin.
A client has a sulfonamide allergy. Which drug would the nurse identify as being contraindicated? meloxicam ibuprofen ketorolac celecoxib
celecoxib
The nurse knows that acetaminophen should not be used in older adults with which condition? diabetes. cirrhosis. chronic obstructive pulmonary disease (COPD). myocardial infarction (MI).
cirrhosis
A group of nursing students are reviewing the pain-relieving action of NSAIDs. The students demonstrate understanding of the information when they identify which actions as being blocked to achieve pain relief? cyclooxygenase-4 cyclooxygenase-2 cyclooxygenase-3 cyclooxygenase-1
cyclooxygenase-2
A client is ordered to receive an nonsteroidal anti-inflammatory drug (NSAID) for pain. The client states that NSAIDs are taken only to decrease inflammation. The nurse instructs the client that these medications are also used for which? increase platelet production. decrease blood pressure. increase appetite. decrease body temperature.
decrease body temperature
What conditions are salicylates are effective in managing? (Select all that apply.) Fever GI upset Infection Inflammation Pain
fever, inflammation, pain
A nurse is conducting a medication reconciliation for an older adult client who has just relocated to the long-term care facility. The nurse notes that the resident has been taking colchicine on a regular basis. Which medication regimen should signal the nurse to the possibility of what diagnosis? Inflammatory bowel disease (IBD) Gout Bursitis or tendonitis Osteoarthritis
gout
A patient is admitted to the emergency department with a suspected overdose of acetaminophen. What adverse effect is most common in acute or chronic overdose of acetaminophen? Hepatotoxicity Pulmonary insufficiency Pancreatitis Nephrotoxicity
hepatotoxicity
A nurse is caring for a client who has just been diagnosed with rheumatoid arthritis. What first-line treatment should the nurse anticipate? ketorolac auranofin balsalazide ibuprofen
ibuprofen
A client who is on long-term acetaminophen therapy has been taking etodolac for joint pain. The nurse would be alert to which effect that may occur because of an interaction between the two drugs? increased risk of bleeding increased absorption of acetaminophen increased effectiveness of nonsteroidal anti-inflammatory drug (NSAID) increased risk of renal impairment
increased risk of renal impairment
A client has been diagnosed with severe rheumatoid arthritis, and hylan G-F 20 has been ordered. How is this drug given? IM orally injected into joint sub Q
injected into joint
Acetaminophen overdose has the potential to cause fatal: kidney damage. liver damage. pancreas damage. lung damage.
liver damage.
A client is receiving auranofin as treatment for rheumatoid arthritis. The nurse should expect this drug to be given by which route? Oral Subcutaneous Intramuscular Intravenous
oral
A 70-year-old woman on long-term ibuprofen therapy for osteoarthritis has returned to the clinic for her regular 6-month visit. The client states that in the last couple of months, she has been having increasing periods of abdominal pain. The nurse suspects that this pain may be related to which? anemia. constipation. peptic ulcer disease or gastritis. interstitial nephritis.
peptic ulcer disease or gastritis
A patient enters the emergency room with reports of visual changes, drowsiness, and tinnitus. The patient is confused and hyperventilating. These symptoms may be attributable to: salicylate intoxication. acute acetaminophen toxicity. caffeine overdose. ibuprofen overdose.
salicylate intoxication.
