Pain and Inflammation ATI

A nurse is planning care for a client who has started taking prednisone. Which of the following interventions should the nurse include? A. Monitor the client's blood glucose. B. Administer an antacid 30 min prior to prednisone. C. Administer aspirin rather than NSAIDs if the client has pain. D. Monitor the client for hyperkalemia.

A Prednisone can cause hyperglycemia. The nurse should monitor the client's blood glucose regularly.

A nurse is teaching a client who has a new prescription for tramadol. Which of the following instructions should the nurse include? Select all that apply. A. Increase fiber and fluid intake. B. Take the drug with food. C. Avoid driving after taking the drug. D. Change positions gradually. E. Reduce exercise level temporarily.

A, B, C, D A: Tramadol can cause constipation and dry mouth. Clients taking the drug should increase fluid and fiber intake to minimize constipation, and sip water, suck on hard candy, or chew gum to relieve dry mouth. B: Tramadol can cause nausea and vomiting. Clients should take the drug with food or milk and lie down if feeling nauseated. C: Tramadol can cause sedation and drowsiness. Clients taking the drug should avoid driving or other activities that require alertness. D: Tramadol can cause sedation and dizziness. Clients taking the drug should use caution when changing positions and ambulating.

A nurse is caring for a client who is about to begin taking aspirin. The nurse should instruct the client to report which of the following manifestations of salicylism? Select all that apply. A. Fever B. Tinnitus C. Diaphoresis D. Thrombophlebitis E. Dizziness

A, B, C, E A: Late manifestations of acute aspirin poisoning, or salicylism, include fever. B: Tinnitus, or ringing or buzzing in the ears, can indicate salicylism. Clients should report this reaction and stop taking aspirin at least until tinnitus resolves. C: Sweating and headache can indicate salicylism. Clients should report these effects and stop taking aspirin at least until the effects resolve. E: Dizziness can indicate salicylism. Clients should report this effect and stop taking aspirin at least until dizziness resolves.

A nurse is caring for a client who is taking allopurinol to treat gout. The nurse should monitor the client for which of the following manifestations of hypersensitivity syndrome? A. Muscle pain B. Fever C. Anxiety D. Tremors

B Allopurinol, an antigout drug, can cause hypersensitivity syndrome. The nurse should monitor the client for rash, itching, or fever, as manifestations of hypersensitivity syndrome, which can lead to renal or liver dysfunction. Clients who develop this type of reaction should stop taking the drug.

A nurse is caring for a client who has a new prescription for celecoxib. The nurse should tell the client to report which of the following adverse drug reactions? A. Tinnitus B. Chest pain C. Constipation D. Diaphoresis

B Celecoxib, a COX-2 inhibitor, can cause cardiovascular or cerebrovascular events. Clients should report chest pain, shortness of breath, headache, numbness, weakness, or confusion. Providers should prescribe the lowest effective dosage of the drug for the shortest time period possible.

A nurse is caring for a client who takes low-dose aspirin to prevent cardiovascular events. The client asks the nurse about taking ibuprofen to treat rheumatoid arthritis. Which of the following responses should the nurse make? A. "Ibuprofen will increase your risk for developing salicylism." B. "Ibuprofen will reduce the cardioprotective effects of low-dose aspirin." C. "Low-dose aspirin will reduce the anti-inflammatory effects of ibuprofen." D. "Low-dose aspirin will reduce the analgesic effects of ibuprofen."

B Ibuprofen, an NSAID, reduces the cardioprotective effects of low-dose aspirin. Clients taking low-dose aspirin for its ability to decrease platelet aggregation should not take ibuprofen.

A nurse is reviewing the medical record of a client who has a new prescription for tramadol. The nurse should identify that which of the following conditions is a contraindication for tramadol? A. Hyperthyroidism B. Seizure disorder C. Rheumatoid arthritis D. Urinary incontinence

B Tramadol, a nonopioid analgesic, can cause seizure activity. Clients who have seizure disorders, head injuries, or increased intracranial pressure should not take tramadol.

A nurse is teaching a client who has a new prescription for allopurinol. The nurse should instruct the client to report which of the following adverse drug reactions? Select all that apply. A. Palpitations B. Sore throat C. Vertigo D. Bruising E. Vision changes

B, C, D, E B: Allopurinol, an antigout drug, can cause agranulocytosis. The nurse should monitor the client's WBC count, and instruct the client to report fever or sore throat. The nurse should also instruct the client to avoid crowds or exposure to people who might have communicable diseases. C: Allopurinol, an antigout drug, can cause drowsiness and vertigo. The nurse should instruct the client to report these adverse effects and avoid activities that require mental alertness until they know how the drug will affect them. D: Allopurinol, an antigout drug, can cause thrombocytopenia. The nurse should monitor the client's platelet count and instruct the client to report any bleeding or bruising. E: Allopurinol, an antigout drug, can cause cataracts with extended use. The nurse should instruct the client to report vision changes, such as cloudiness or halos around lights, and have eye examinations at recommended intervals.

A nurse is caring for a client who is receiving morphine to relieve severe pain. The nurse should monitor the client for which of the following adverse drug reactions? Select all that apply. A. Diarrhea B. Urinary retention C. Respiratory depression D. Sedation E. Orthostatic hypotension

B, C, D, E B: Morphine can cause urinary retention. The nurse should monitor the client's fluid intake and output and assess for bladder distention. C: Morphine can cause severe respiratory depression. The nurse should withhold the drug for a respiratory rate below 12/min. D: Morphine can cause sedation, dizziness, and lightheadedness. Clients who are taking the drug should avoid activities that require alertness. E: Morphine can cause hypotension and postural hypotension. Clients who are taking the drug should change positions gradually.

A nurse is teaching a client who has a new prescription for prednisone. Which of the following instructions should the nurse include? Select all that apply. A. Reduce the dose during periods of stress. B. Discontinue the drug gradually. C. Report illness or infection. D. Increase intake of calcium and vitamin D. E. Monitor for signs of gastric bleeding.

B, C, D, E B: Prednisone, a glucocorticoid, suppresses adrenal function. The nurse should instruct the client to taper the dosage before discontinuing it to allow for resumption of adrenal activity. C: Clients can need higher doses of prednisone during illness or infection. The nurse should instruct the client to report signs of infection. D: Prednisone, a glucocorticoid, can cause bone loss and reduced calcium absorption. The nurse should instruct the client to increase their intake of calcium and vitamin D. E: Prednisone, a glucocorticoid, can cause peptic ulcer disease. The nurse should instruct the client to report signs of gastric bleeding, such as hematemesis or black tarry stools.

A nurse is caring for a client who has a new prescription for butorphanol. The nurse should monitor the client for which of the following adverse drug reactions? Select all that apply. A. Infection B. Nausea C. Tachycardia D. Dizziness E. Headache

B, D, E B: Butorphanol, an opioid agonist-antagonist, can cause nausea. Clients who are taking the drug should lie down when feeling nauseated. D. Butorphanol, an opioid agonist-antagonist, can cause dizziness and drowsiness. Clients who are taking the drug should avoid activities that require alertness. E. Butorphanol, an opioid agonist-antagonist, can cause headaches and increased intracranial pressure. Clients who are taking the drug should report severe headaches.

A nurse is caring for a child who has a viral infection. The nurse should identify that which of the following drugs can increase the risk of Reye syndrome in children who have viral infections? A. Butorphanol B. Acetaminophen C. Tramadol D. Aspirin

D Aspirin can increase the risk for Reye syndrome in children who have a viral infection, particularly chickenpox or influenza. Manifestations of Reye syndrome include lethargy and persistent vomiting.

A nurse is caring for a group of postoperative clients. The nurse should identify that morphine is contraindicated for which of the following clients? A. A client who had a mastectomy B. A client who had a knee arthroplasty C. A client who had a colectomy D. A client who had a cholecystectomy

D Morphine can cause biliary colic. It should not be administered to a client who has just had biliary tract surgery, such as a cholecystectomy.

A nurse is caring for a client who currently takes furosemide and has a new prescription for prednisone. The nurse should monitor the client for which of the following manifestations during concurrent use of the two drugs? A. Hypercalcemia B. Hypoglycemia C. Hypothermia D. Hypokalemia

D Prednisone, a glucocorticoid, can cause hypokalemia. The risk for this electrolyte imbalance increases when the client is taking potassium-depleting diuretics, such as furosemide. The nurse should clarify the prescription with the provider and monitor the client's potassium levels.

A nurse is caring for a client who is taking naloxone to treat acute morphine toxicity. The nurse should monitor the client for which of the following adverse drug reactions? Select all that apply. A. Increased respiratory rate B. Increased pain C. Thrombophlebitis D. Ventricular arrhythmias E. Hypertension

A, B, D, E A: Naloxone treats respiratory depression, but it can cause hyperventilation. It is essential for the nurse to monitor the client's respiration and oxygenation. B: Naloxone reverses the analgesic effects of opioids and can cause increased pain and discomfort. The nurse should assess the client's pain frequently. D: Naloxone can cause ventricular arrhythmias. The nurse should monitor the client's heart rate and ECG. E: Naloxone can cause hypertension. The nurse should monitor the client's blood pressure.

A nurse is caring for a client who asks about taking acetaminophen. The nurse should identify that acetaminophen is indicated for which of the following conditions? Select all that apply. A. To reduce fever B. To decrease inflammation C. To relieve mild pain D. To promote sedation E. To alleviate anxiety

A, C A: Acetaminophen reduces fever. It is important, however, to monitor clients taking the drug for signs of hepatotoxicity. C: Acetaminophen relieves mild to moderate pain. It is important, however, to monitor clients who take high doses for early signs of toxicity, including sweating, nausea, diarrhea, and abdominal discomfort.

A nurse is caring for a client who is taking acetaminophen at regular intervals for mild discomfort. The nurse should tell the client to report which of the following early indications of acetaminophen toxicity? Select all that apply. A. Diaphoresis B. Palpitations C. Shortness of breath D. Nausea E. Diarrhea

A, D, E A: Acetaminophen toxicity can cause diaphoresis, anorexia, and, eventually, liver damage. Clients should follow the dosage guidelines on the labels of over-the-counter drugs carefully to avoid toxicity. D: Acetaminophen toxicity can cause nausea, vomiting, and anorexia, and can lead to liver damage. E: Acetaminophen toxicity can cause diarrhea, lethargy, and, eventually, liver damage.

A nurse is reviewing the medical record of a client who has a new prescription for celecoxib. The nurse should identify that which of the following conditions is a contraindication to celecoxib? A. Rheumatoid arthritis B. Ankylosing spondylitis C. Sulfonamide allergy D. Adrenocortical insufficiency

C Clients who are allergic to sulfonamides can have severe allergic reactions to celecoxib, a COX-2 inhibitor. Clients who are allergic to salicylates can also react adversely to celecoxib.

A nurse is reviewing the drug list for a client who has a new prescription for allopurinol. The nurse should identify that which of the following drug interacts with allopurinol? A. Warfarin B. Ibuprofen C. Insulin D. Furosemide

A Allopurinol can increase the effectiveness of warfarin. A lower dosage of warfarin might be required.

A nurse is caring for a client who has a new prescription for prednisone for long-term treatment of rheumatoid arthritis. The nurse should monitor the client for which of the following adverse drug reactions? A. Pulmonary embolism B. Hepatitis C. Bone loss D. Breast cancer

C Prednisone, a glucocorticoid, can cause osteoporosis, especially with long-term use. Clients who are taking the drug should increase weight-bearing activity and report back pain. The nurse should monitor the client's bone density.

A nurse is reviewing the medical record of a client who reports taking acetaminophen at home. The nurse should identify that which of the following client conditions is a contraindication for acetaminophen? A. Asthma B. Diabetes mellitus C. Heart failure D. Alcohol use disorder

D Acetaminophen can cause liver toxicity. Clients who have a history of alcohol use disorder should not take acetaminophen.

A nurse is teaching a client who is taking allopurinol about minimizing adverse effects. Which of the following instructions should the nurse include? A. Eat a small meal before taking the drug. B. Suck on hard candy or chew gum. C. Take a stool softener daily. D. Avoid the use of NSAIDs.

A Taking allopurinol after eating a meal or drinking a glass of milk can prevent stomach upset.

A nurse is teaching a client who has a new prescription for allopurinol. Which of the following instructions should the nurse include? A. Avoid driving or activities that require mental alertness. B. Avoid crushing the tablets. C. Limit fluid intake during therapy. D. Limit potassium while taking allopurinol.

A Allopurinol can cause drowsiness. The nurse should instruct the client to avoid driving or activities that require mental alertness until they know the effect the drug will have on them.

A nurse is caring for a client who is opioid dependant and has a new prescription for butorphanol. The nurse should monitor the client for which of the following manifestations of abstinence syndrome? Select all that apply. A. Bronchospasm B. Vomiting C. Peripheral edema D. Abdominal cramps E. Hypertension

B, D, E B: Abstinence syndrome can cause nausea, vomiting, and anorexia. D: Abstinence syndrome can cause abdominal cramps and anorexia. E: Abstinence syndrome can cause hypertension, tremors, and fever.

A nurse is caring for a client who has a prescription for aspirin to treat an ankle sprain. The nurse should instruct the client to report which of the following adverse drug reactions? A. Polyuria B. Bone pain C. Weight gain D. Infection

C Aspirin use can cause renal impairment, which can result in the retention of salt and water. Clients should report reduced urine output, weight gain, edema, or bloating. The nurse should monitor BUN and creatinine levels and stop aspirin therapy for clients who develop signs of renal dysfunction.