Chp 25 Antiinflammatory Drugs

A client is receiving auranofin (Ridaura). Which instruction takes priority? a. "You may have a salty taste in your mouth." b. "You may experience constipation." c. "You may experience visual changes." d. "You'll need frequent blood counts drawn."

ANS: D Agranulocytosis and thrombocytopenia are potentially life-threatening adverse reactions to the medication.

The client has been ordered to be treated with Benemid. What is the highest priority instruction to give the client? a. "Take on an empty stomach." b. "Increase fluid intake." c. "Take with food." d. "Limit fluid intake."

ANS: B The client who is being treated with Benemid should increase his fluid intake because this will promote the urinary excretion of uric acid.

The client has been ordered to be treated with Ridaura. The nurse anticipates seeing an increased _____ in the client's laboratory results. a. fasting blood glucose b. liver enzyme tests c. potassium level d. calcium level

ANS: B The client who is being treated with Ridaura may exhibit a slight increase in liver enzyme tests.

A group of clients cared for by the nurse is ordered to take NSAIDs. Which client instruction would the nurse question? a. Instruct the client not to take aspirin and other NSAIDs together. b. Instruct the client to take NSAIDs with meals or 8 ounces of fluid. c. Instruct women to take NSAIDs during heavy menstrual flow for pain. d. Instruct the client to avoid alcohol when taking NSAIDs.

ANS: C NSAIDs may increase the client's bleeding time, which may increase bleeding time during menstrual periods.

A client is ordered to receive celecoxib (Celebrex) for chronic pain caused by osteoarthritis. The nurse anticipates that the client will exhibit: a. an increase in pain level. b. an increase in bleeding time. c. erosion of the stomach lining. d. a decrease in inflammation.

ANS: D A decrease in inflammation is the anticipated function of this medication.

A client is ordered to receive aspirin after an acute heart attack. The nurse is evaluating use of this medication with other medications. The nurse is aware that aspirin can cause which drug interaction? a. Increased risk of bleeding with anticoagulants b. Decreased risk of hypoglycemia with oral hypoglycemic drugs c. Decreased ulcerogenic effect with glucocorticoids d. Increased risk of infection with amoxicillin

ANS: A ASA is an anticoagulant that may increase the bleeding time when used with other anticoagulants.

Clients with which disorders are most often responsive to the NSAID groups of medications? a. Rheumatoid arthritis and osteoarthritis b. Postoperative pain and discomfort c. Infections and incisional pain d. Gastrointestinal discomfort and bleeding

ANS: A NSAIDs assist with pain and inflammation. Postoperative and incisional pain should be treated with narcotics. The NSAIDs should not be used with the client who is exhibiting gastrointestinal discomfort and bleeding.

A client with rheumatoid arthritis is ordered to receive tumor necrosis factor (TNF) as treatment for symptoms. Which manifestations are of most concern to the nurse? a. Elevated temperature and a sore throat b. Decreased range of motion and crepitation c. Constipation and abdominal pain d. Poor skin turgor and increased urine specific gravity

ANS: A TNF may cause immunosuppression and increased risk for infection.

A client is ordered to receive an NSAID for osteoarthritis. Which nursing intervention will treat the side effect most commonly associated with the NSAIDs? a. Taking the medication with meals b. Using sunscreen c. Avoiding crowds d. Encouraging deep breathing

ANS: A The most common side effect is gastric upset, so taking the medication with meals will alleviate/assist with these symptoms.

A nurse is teaching a client who has been prescribed NSAIDs for osteoarthritis. The nurse instructs the client that the best time to take the medication will be: a. upon rising. b. with meals. c. on an empty stomach. d. at bedtime.

ANS: B GI upset is a classic side effect of the NSAIDs; therefore the medication should be taken with meals.

A client is ordered to receive gold therapy. The client asks how long it will take for him to feel the effects of this medication. The nurse teaches the client that gold medications: a. achieve the desired effect in 1 to 2 months. b. achieve the desired effect in 3 to 4 months. c. alleviate symptoms immediately. d. are effective within 7 days of therapy.

ANS: B Gold therapy, or chrysotherapy, takes 3 to 4 months to reach effective levels.

A client is ordered to receive an NSAID for a disorder. The client states that she is aware that NSAIDs are frequently taken to decrease inflammation. The nurse clarifies that these agents may also be taken to: a. decrease pulse rate. b. reduce body temperature. c. decrease blood pressure. d. increase platelet aggregation.

ANS: B One of the functions of NSAIDs is to reduce body temperature.

A client diagnosed with acute gout is prescribed allopurinol (Zyloprim). The nurse is reviewing the client's medication history and will contact the healthcare provider if the client is taking: a. diphenhydramine (Benadryl). b. metoclopramide (Reglan). c. propranolol (Inderal). d. warfarin (Coumadin).

ANS: D Allopurinol (Zyloprim) increases the effects of warfarin (Coumadin). Allopurinol does not interact with diphenhydramine, metoclopramide, and propranolol.

The client has been ordered to be treated with allopurinol. He complains to the nurse that he has noted changes in his vision. What is the most appropriate nursing intervention? a. Explain to the client that this is an expected response to the drug. b. Call the physician; this is a life-threatening response to the drug. c. Explain to the client that this is a normal side effect of the drug. d. Call the physician; this is an adverse reaction to the drug.

ANS: D An adverse reaction to allopurinol is the development of cataracts and retinopathy.

In teaching a client about NSAIDs, the nurse is careful to teach about how to monitor for side effects. What side effect is of special concern? a. Tachycardia b. Polyuria c. Elevated temperature d. Gastrointestinal upset or distress

ANS: D NSAIDs commonly cause gastrointestinal lining breakdown that may lead to ulceration.

The client is an older adult who has been diagnosed with cardiac arrhythmias. She has been ordered to be treated with Remicade. What should the nurse do? a. Administer the medication as ordered by the physician. b. Administer the drug after clarifying the dose with the pharmacist. c. Hold the drug and conduct the physician; the dosage should be decreased. d. Hold the drug and contact the physician; the drug is contraindicated.

ANS: D Remicade is contraindicated when the client is elderly and is experiencing cardiac arrhythmias.

Client teaching related to colchicine (Novocolchine) includes which instruction? a. "Take the drug on an empty stomach." b. "Keep fluid intake to no more than 1000 mL daily." c. "Take a laxative daily to prevent constipation." d. "Take the drug with food."

ANS: D The drug should be taken with food to avoid gastric upset.

Indomethacin (Indocin) is highly protein bound and is ordered as a new medication for the client. The client is taking another medication that is moderately protein bound. Upon administration of both medications, the nurse should be most concerned with: a. indomethacin toxicity. b. indomethacin levels below the therapeutic level. c. an increase in medication side effects. d. toxic levels of the first drug.

ANS: D The indomethacin would replace the first drug, allowing more of the first medication free for active drug levels.

A client is ordered to receive a medication to relieve inflammation. The nurse determines that the medication is needed quickly. The nurse anticipates that which drug form will be ordered so that the medication can be released rapidly? a. Tablet b. Enteric-coated pill c. Capsule d. Liquid suspension

ANS: D This medication does not need to go through the dissolution phase, so it is more rapidly absorbed.