Chapter 16

Patients are often given a daily dose of aspirin for prophylaxis of myocardial infarction (MI), transient ischemic attacks (TIA), and cerebrovascular accident (CVA). What is the recommended daily dose for this purpose? 600-650 mg 360-460 mg 81-325 mg 180-240 mg

81-325 mg

Which of the following patients would the nurse determine has the highest risk of cumulative toxicity if prescribed colchicine? A patient with hepatic disease A patient with myelosuppression A pregnant patient A patient undergoing radiation therapy

A patient with hepatic disease

A male client is seeking an over-the-counter medication to ease both the pain and inflammation associated with his osteoarthritis of his knee. The nurse knows that which drug will only reduce pain? • Ibuprofen • Aspirin • Naproxen sodium • Acetaminophen

Acetaminophen

What is an important nursing action for the administration of colchicine to the patient in the acute care setting?

Administer the medication with a full glass of water at evenly spaced intervals throughout the day. Explanation: In an acute care setting, administer colchicine with a full glass of water at evenly spaced intervals throughout the day.

What should a nurse recognize as a property of ibuprofen/Motrin? (Select all that apply.) • Antibacterial • Anti-inflammatory • Analgesic • Antipruritic • Antipyretic

Anti-inflammatory Analgesic Antipyretic

Acetaminophen is frequently used as a substitute for aspirin. What effects of aspirin are absent in acetaminophen? • Antiplatelet and antipyretic effects • Anti-inflammatory and analgesic effects • Analgesic and antipyretic effects • Anti-inflammatory and antiplatelet effects

Anti-inflammatory and antiplatelet effects

A client's history reveals an allergy to sulfonamides. The nurse understands that which drug would be contraindicated? • Diclofenac • Naproxen • Celecoxib • Ibuprofen

Celecoxib

The 56-year-old client is diagnosed with osteoarthritis and reports joint pain and stiffness. Which medication would be identified as appropriate for the client to take? Eletriptan Sumatriptan Ergotamine Celecoxib

Celecoxib

The 56-year-old client is diagnosed with osteoarthritis and reports joint pain and stiffness. Which medication would be identified as appropriate for the client to take?

Celecoxib Explanation: Celecoxib is a COX-2 inhibitor used to treat pain related to osteoarthritis. Eletriptan, sumatriptan, and ergotamine are medications used to treat migraines.

Mr. Gregory is being treated for gout with colchicine. He has been taking the medication for over a year now. What is the main adverse reaction of long-term therapy with this medication?

Depressed bone marrow function Explanation: Long-term colchicine therapy can cause depressed bone marrow function, inducing aplastic anemia, pancytopenia, thrombocytopenia, leukopenia, or agranulocytosis. GI tract distress, nausea, vomiting, diarrhea, abdominal pain, and paralytic ileus are some of the adverse effects that may occur even in short-term colchicine therapy. On the other hand, renal or hepatic failure is not a possible adverse effect of long-term colchicine therapy.

A 78-year-old male client calls the clinic and reports severe pain and swelling in his right great toe. The client states that the pain is worse at night and has been present for at least 2 weeks. The nurse understands that this client has what type of inflammatory disorder?

Gout Explanation: Severe pain and swelling in the great toe that is worse at night and lasts longer than 10 days is most likely gout.

The nurse instructs the client that with the use of nonsteroidal anti-inflammatory drugs (NSAIDs) some adverse reactions can occur. Which are they? Select all that apply. Hematuria Dysmenorrhea Somnolence Purpura Ecchymosis

Hematuria Somnolence Purpura Ecchymosis

An older adult male patient has begun treatment for gout after an extensive diagnostic workup. The nurse who is contributing to the patient's care should understand that gout is a result of what pathophysiological process? • Hyperuricemia causes crystals to precipitate in the synovial fluid. • Excess purine intake initiates an autoimmune process that impairs joint function. • Lack of joint mobility causes impaired uric acid metabolism. • Mechanical damage to the joints results in increased release of uric acid.

Hyperuricemia causes crystals to precipitate in the synovial fluid.

A nurse is caring for a client in the early stage of rheumatoid arthritis. The nurse would expect which medication classification to be used in the treatment of this client? Uricosuric agents Xanthine oxidase inhibitors Antimalarial agents Nonsteroidal anti-inflammatory drugs (NSAIDs)

Nonsteroidal anti-inflammatory drugs (NSAIDs)

A client has just returned from x-ray after reporting pain in her joints. The x-rays indicate damage of the joint spaces. This is indicative of which disease process? Scleroderma Osteoarthritis Gout Fibromyalgia

Osteoarthritis

A nurse caring for a patient administered an NSAID for fever reduction records a decrease in urinary output for the patient. Which of the following should the nurse consider as a probable reason for the patient's condition? Prolonged immobility Intake of food with antacids Prolonged temperature elevation Reduced intake of fibrous food

Prolonged temperature elevation

A nurse caring for a patient administered an NSAID for fever reduction records a decrease in urinary output for the patient. Which of the following should the nurse consider as a probable reason for the patient's condition?

Prolonged temperature elevation Explanation: If temperature elevation is prolonged while on NSAID therapy, hot, dry, flushed skin and a decrease in urinary output may develop; consequently, dehydration can occur. Prolonged immobility, reduced intake of fibrous food, and intake of food with antacids do not cause a decrease in urinary output.

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?

Salicylate intoxication Explanation: Symptoms of salicylate intoxication include nausea, vomiting, fever, fluid and electrolyte deficiencies, tinnitus, decreased hearing, visual changes, drowsiness, confusion, and hyperventilation. The scenario described does not suggest acetaminophen poisoning, ibuprofen overdose, or caffeine abuse.

Which of the following agents would be least appropriate to use as treatment for ulcerative colitis? • Salsalate • Mesalamine • Olsalazine • Balsalazide

Salsalate

Which of the following agents would be least appropriate to use as treatment for ulcerative colitis?

Salsalate Explanation: Salsalate is used to treat pain, fever, and inflammation in adults. Balsalazide can be used to treat mild to moderate acute ulcerative colitis in adults. Olsalazine can be used to treat ulcerative colitis and other inflammatory bowel diseases in adults. Mesalamine is used to treat ulcerative colitis and other inflammatory bowel diseases in adults.

A nurse is teaching a patient about his newly prescribed drug, colchicine, for gout. The nurse will instruct the patient to avoid which of the following foods? • Eggs • Milk • Green beans • Shrimp

Shrimp

A patient with muscular pain has been prescribed an NSAIDs. What advice should the nurse give the patient to promote an optimal response to NSAID therapy?

Suggest the patient take the NSAID with food and milk. Explanation: The nurse should suggest that the patient take the drug with food and milk to promote an optimal response to NSAID therapy; this helps minimize the risk of GI effects. The patient does not need to take an NSAID with fiber-rich food or with calcium supplements.

A 64-year-old client has been prescribed ibuprofen for osteoarthritis. Which adverse reaction should the client report with the use of ibuprofen?

Tarry stool Explanation: Serious GI events are also listed as a Black Box warning. Gastropathies are commonly associated with ibuprofen. Nausea, vomiting, diarrhea, constipation, flatulence, and abdominal pain may be representative of minor adverse effects in some clients or serious GI toxicity in others. During long-term administration, the most serious effects are peptic ulcer disease or gastritis that leads to GI bleeding or even perforation. These events can occur at any time, with or without warning.

The nurse would question the health care provider who prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) for which client?

The client diagnosed with peptic ulcers Explanation: The client diagnosed with peptic ulcer disease is at risk for further GI irritation and bleeding if given NSAIDs, so the nurse would question the health care provider who ordered this drug. Clients with diabetes and psoriasis may take NSAIDs safely and the nurse would not question the order. NSAIDs are often ordered for pain control for clients following vaginal birth and this order need not to be questioned

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 less expensive and more efficient for pain relief." • "Acetaminophen is often the initial drug of choice for relieving mild to moderate pain." • "Acetaminophen will reduce the inflammation causing your headache." • "Acetaminophen is more effective than ibuprofen for headaches."

"Acetaminophen is often the initial drug of choice for relieving mild to moderate pain."

An older adult woman has been experiencing significant joint pain and has informed her primary care provider that she has begun taking aspirin two to three times each day. What aspect of this patient's medical history may contraindicate the use of aspirin? The patient takes an SSRI for depression. The patient had a total abdominal hysterectomy 2 years ago. The patient has a history of peptic ulcer disease. The patient has a diagnosis of type 2 diabetes.

The patient has a history of peptic ulcer disease.

An older adult woman has been experiencing significant joint pain and has informed her primary care provider that she has begun taking aspirin two to three times each day. What aspect of this patient's medical history may contraindicate the use of aspirin?

The patient has a history of peptic ulcer disease. Explanation: Due to the risk of bleeding, aspirin is contraindicated in patients with peptic ulcer disease or bleeding disorders. SSRIs, previous surgery, and type 2 diabetes do not preclude the use of aspirin

The nurse is conducting a medication reconciliation of a new resident of a long-term care facility. The nurse notes that the resident takes allopurinol on a daily basis for the treatment of gout. What is the primary purpose of this drug? To achieve pain relief in joints affected by gout To potentiate the metabolism of dietary purines To promote the remodeling of damaged synovium To balance urate concentration and reduce the symptoms of gout

To balance urate concentration and reduce the symptoms of gout

The client has been prescribed one aspirin a day. The nurse understands that is prescribed for which of the following? • To inhibit platelet aggregation • To decrease pain • To treat osteoarthritis • To decrease temperature

To inhibit platelet aggregation

A client with mild low back pain has been advised to take acetaminophen. The nurse teaching the client about this medication would include that excessive intake of acetaminophen may result in which?

liver damage. Explanation: A client taking acetaminophen should be taught the common adverse effects of the drug, which include rash, urticaria, and nausea. Nausea, not gastrointestinal distress, is a common adverse effect of acetaminophen. Flushing, dizziness, and feelings of tingling, heat, and fatigue are the most common adverse effects of sumatriptan, not acetaminophen.

An adult client is brought to the emergency department after deliberately overdosing on acetaminophen. The care team should prioritize interventions based on the client's risk for which adverse reaction? seizures acute GI bleed gastric perforation liver failure

liver failure

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?

peptic ulcer disease or gastritis. Explanation: During long-term ibuprofen therapy, especially in clients older than 60 years, the nurse needs to closely monitor for peptic ulcer disease or gastritis that can lead to gastrointestinal bleeding or even bowel perforation. These events can occur at any time, with or without warning. Ibuprofen may also cause excessive or abnormal bleeding, especially in clients with anemia, but it is not known to cause anemia. Interstitial nephritis is one of the less common renal toxicities associated with ibuprofen as is constipation.

A nurse is presenting an educational event for a group of new parents. A participant has asked about the safe use of acetaminophen in children. What should the nurse teach the parents? "Monitor your child's temperature carefully and regulate the acetaminophen dose based on the fever." "It's best not to give acetaminophen to a child under 13 unless you receive a doctor's order." "Mix OTC children's medications to get the best coverage for your child's symptoms, but make sure not to exceed the recommended dose of each medication." "Check the label of over-the-counter medications carefully to see if they include acetaminophen."

"Check the label of over-the-counter medications carefully to see if they include acetaminophen."

How should the nurse counsel a client concerning a new prescription for celecoxib and its affect on long-standing low-dose acetylsalicylic acid therapy? "Continue both therapies as prescribed." "Stop taking the acetylsalicylic acid for at least 7 days before starting the celecoxib." "Take the acetylsalicylic acid within 4 hours of taking the celecoxib." "Increase the daily dosage of acetylsalicylic acid to 325 mg."

"Continue both therapies as prescribed."

A client diagnosed with gout reports having no symptoms of the disease and asks why allopurinol was prescribed. How will the nurse best respond?

"It is used to prevent or treat hyperuricemia, which occurs with gout." Explanation: Allopurinol is the drug of choice for gout due to "overproduction" of uric acid. It is used to prevent or treat (but not cure) hyperuricemia, by preventing formation of uric acid and promoting resorption of urate deposits.

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? "This drug hasn't been definitively proven to be unsafe, so it's still available." "A final decision from the FDA on whether Celebrex is safe will be released in 2018." "As long as you take your heart medications, you'll be fine." "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."

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 often the initial drug of choice for relieving mild to moderate pain." Explanation: Acetaminophen is often the initial drug of choice for relieving mild to moderate pain and fever, because it does not cause gastric irritation or bleeding. It may be taken on an empty stomach.

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 is used to prevent or treat hyperuricemia, which commonly occurs with 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 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 prevent or treat hyperuricemia, which commonly occurs with gout."

A female client with acute joint inflammation asks the nurse why she shouldn't use acetaminophen for her condition. What would be the nurse's best response to this client? "The drug can increase your risk for bleeding." "This drug is reserved for long-term therapy." "The drug has quite a few adverse effects." "The drug has no effect on inflammation."

"The drug has no effect on inflammation."

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." Explanation: All anti-inflammatory drugs available OTC have adverse effects that can be dangerous if toxic levels of the drug circulate in the body. Since these drugs are available OTC, there is a potential for abuse and overdosing. In addition, these drugs block the signs and symptoms of a present illness. OTC agents, if combined with other drugs, can induce toxicity.

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? "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." "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."

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?

"Yes, low doses of aspirin may increase your risk of bleeding; I will call you with your new prescriber's orders." Explanation: If a client has a history of taking aspirin, including the low doses prescribed for antithrombotic effects, there is a risk of bleeding from common therapeutic procedures (e.g., intramuscular injections, venipuncture, insertion of urinary catheters or GI tubes) or diagnostic procedures (e.g., drawing blood, angiography).

Patients are often given a daily dose of aspirin for prophylaxis of myocardial infarction (MI), transient ischemic attacks (TIA), and cerebrovascular accident (CVA). What is the recommended daily dose for this purpose?

81-325 mg Explanation: The recommended daily dose for prophylaxis of MI, TIA, and CVA is 81-325 mg. The indication stems from aspirin's ability to decrease formation of blood clots.

Which client is at highest risk for developing hepatotoxicity related to the use of acetaminophen? • A female 50 years of age with hypoprothrombinemia • A female 62 years of age with a vitamin K deficiency • A male 30 years of age who drinks four beers per day • A male 40 years of age with arthritis

A male 30 years of age who drinks four beers per day

Which of the following patients would the nurse determine has the highest risk of cumulative toxicity if prescribed colchicine?

A patient with hepatic disease Explanation: Colchicine is eliminated primarily through the biliary tract. Therefore, patients with hepatic disease face the highest risk for cumulative toxicity, if they were to be administered colchicine. Patients with myelosuppression are at risk for infections or bleeding. Patients undergoing radiation therapy do not face the risk of drug toxicity. Pregnant women do not face an increased risk of cumulative toxicity; however, colchicine is in pregnancy category D and should never be given in pregnancy.

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 Explanation: Acetaminophen is the most frequently used drug for managing fever and pain in children. Ibuprofen and naproxen are both effective treatments for pain and fever in children but they are not the most commonly used medications. Indomethacin is not indicated for fever control.

The development of gout has three distinct phases. Place in order each phase of the development of gout.

Acute gouty arthritis Intercritical gout Chronic tophaceous gout Explanation: Gout has three distinct phases: acute gouty arthritis (flares), intercritical gout (interval between flares), and chronic tophaceous gout (uncontrolled hyperuricemia with chronic arthritis tophi).

What is an important nursing action for the administration of colchicine to the patient in the acute care setting? • Continue the drug if diarrhea occurs because this is a normal adverse effect. • Administer the medication with a full glass of water at evenly spaced intervals throughout the day. • Administer the medication with ibuprofen to alleviate the pain until the colchicine begins to work. • Ensure that the patient is receiving foods high in purine.

Administer the medication with a full glass of water at evenly spaced intervals throughout the day.

Mr. Conn, age 65, is taking probenecid for treatment of chronic gouty arthritis. When providing patient and family education, what should a nurse advise the patient to do if he misses a dose and it is almost time for the next dose?

Advise the patient to take only the second dose and ignore the missed dose. Explanation: If a patient misses a dose, it should be taken as soon as possible. If it is almost time for the next dose, however, only that dose should be taken; the patient should never take double or extra doses. It is not essential to undergo blood or urine tests or stop the medication unless symptoms of any adverse effects occur.

What drug is useful in the management of gout because of its ability to inhibit the formation of uric acid crystals? • Colchicine • Salicylic acid • Probenecid • Allopurinol

Allopurinol

Acetaminophen is frequently used as a substitute for aspirin. What effects of aspirin are absent in acetaminophen?

Anti-inflammatory and antiplatelet effects Explanation: Acetaminophen is commonly used as an aspirin substitute, because it lacks aspirin's antiplatelet effects. It also lacks aspirin's anti-inflammatory effect. Acetaminophen has antipyretic and analgesic effects equal to those of aspirin.

Which drug is used to decrease the risk of myocardial infarction in patients with unstable angina or previous myocardial infarction? Magnesium salicylate Aspirin Salsalate Diflunisal

Aspirin

Which statements are true of aspirin's effects on platelets? (Select all that apply.)

Aspirin inhibits platelet aggregation. The effect of aspirin on platelets is irreversible. Explanation: Aspirin prolongs bleeding time by inhibiting the aggregation of platelets. The effect of aspirin on platelets is irreversible and lasts for the life of the platelet (7 to 10 days).

The nurse teaches the client to do which of the following prior to surgery?

Avoid salicylates. Explanation: The client should avoid products containing aspirin for at least one week prior to surgery, to decrease the risk of bleeding. Acetaminophen has no effect on bleeding.

Aspirin (ASA) is an over-the-counter drug that is found in many other drugs. What is the mechanism of action for aspirin?

Blocking the transmission of pain impulses Explanation: Aspirin acts both centrally and peripherally to block the transmission of pain impulses. Aspirin does not increase adrenal function or while blood cell production. Aspirin does not suppress the function of the hypothalamus.

A 33-year-old man has developed acute gouty arthritis. He has been prescribed colchicine. When developing a care plan for this patient, which factor will be most important for the nurse to consider?

Dietary habits Explanation: The nurse must consider the patient's dietary habits because foods high in purines increase uric acid concentrations in the blood, making a gouty attack more likely. Assessing the patient's work environment, fluid intake, and ethnicity are not as important as assessing his dietary habits.

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 • Alcohol can be used in moderation only • Severe diarrhea is an expected response • Follow a low purine diet

Follow a low purine diet

A 78-year-old male client calls the clinic and reports severe pain and swelling in his right great toe. The client states that the pain is worse at night and has been present for at least 2 weeks. The nurse understands that this client has what type of inflammatory disorder? Probable fracture of the toe Spondylarthritis Gout Osteoarthritis of the toe

Gout

A nurse has admitted a 10-year-old to the short-stay unit. The child reports chronic headaches, and his mother states that she gives the child acetaminophen at least twice a day. What will the nurse evaluate?

Hepatic function Explanation: The nurse should evaluate the patient's hepatic function. Severe hepatotoxicity can occur from over use of acetaminophen. Significant interferences do not occur in the kidney, heart, or lung with acetaminophen

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 allergic reaction Increased risk for toxicity

Increased risk for bleeding

What best describes the action of nonsteroidal anti-inflammatory drugs (NSAIDs)? Blocks hypothalamus activity Act directly on thermoregulatory cells Inhibit phagocytosis Inhibit prostaglandin synthesis

Inhibit prostaglandin synthesis

A nurse will monitor which of the following when assigned to a patient taking allopurinol for chronic gout who visits the clinic every 2 months? Body temperature Blood sugar levels Blood pressure Liver function tests

Liver function tests

What information should be provided to a client diagnosed with an acetylsalicylic acid allergy? • Nonsteroidal anti-inflammatory drugs (NSAIDs) should always be taken with food. • Nonsteroidal anti-inflammatory drugs (NSAIDs) should be taken for only short periods of time. • Nonaspirin form of nonsteroidal anti-inflammatory drugs (NSAIDs) should be avoided. • It is safe to use only buffered forms of acetylsalicylic acid.

Nonaspirin form of nonsteroidal anti-inflammatory drugs (NSAIDs) should be avoided.

A 65-year-old man who just had a heart attack is placed on aspirin, 81 mg daily. The nurse is explaining the purpose of this medication to the client and his wife. What would be the nurses best explanation?

The aspirin is being prescribed because it reduces your risk of a second heart attack. Explanation: Because of its antiplatelet and anti-inflammatory effects, low-dose aspirin (81 mg daily) is useful in preventing or reducing the risk of transient ischemic attacks (TIAs), MI, and ischemic cerebral vascular accident (stroke). It is also indicated for clients with a previous MI, chronic or unstable angina, and those undergoing angioplasty or other revascularization procedures.

The client has been prescribed one aspirin a day. The nurse understands that is prescribed for which of the following?

To inhibit platelet aggregation Explanation: Daily low-dose aspirin is prescribed to inhibit platelet aggregation within the heart and brain. Aspirin for osteoarthritis and pain is usually prescribed at a higher dosage. If the client is having elevated temperatures daily, the cause would need to be investigated.

A parent has brought a 6-year-old child to the clinic. The child has a fever of 102.8°F (39.3°C) and is subsequently diagnosed with the flu. What medication best balances risks and benefits for treating this client's fever? penicillamine etanercept aspirin acetaminophen

acetaminophen

A nurse will instruct a patient taking allopurinol to take each dose • first thing in the morning. • at night. • after a meal. • before a meal.

after a meal.

A 60-year-old man has told the nurse that he has been treating his joint pain with regular doses of ibuprofen. In order to ascertain the man's risks of experiencing adverse effects, the nurse should assess the patient's alcohol intake. body mass index. skin integrity. calcium intake.

alcohol intake.

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. cataract. acute gout.

allergy to sulfonamides.

A nurse is aware that a client prescribed meloxicam is most likely being treated for what health problem?

arthritis Explanation: Meloxicam is administered for the treatment of osteoarthritis and rheumatoid arthritis. It has no effect on any of the other options.

When assessing a client who is to receive celecoxib, a history of which disease process or condition would be important to assess? diabetes peptic ulcer cardiac disease respiratory disorder

cardiac disease

Which nonsteroidal anti-inflammatory drug (NSAID) appears to work by specifically inhibiting cyclooxygenase-2 (COX-2) without inhibiting cyclooxygenase-1 (COX-1)? • meloxicam • naproxen • ibuprofen • celecoxib

celecoxib

A client with rheumatic disease is being prescribed salicylate therapy. The nurse should teach the client monitor himself or herself for which adverse effects? increased hair growth irritation of oral mucosa visual changes ringing in the ears

ringing in the ears

A female client with acute joint inflammation asks the nurse why she shouldn't use acetaminophen for her condition. What would be the nurse's best response to this client?

• "The drug has no effect on inflammation." Explanation: The drug has antipyretic and analgesic properties, but no anti-inflammatory properties. Acetaminophen does have adverse effects including hepatotoxicity secondary to chronic use or overdose. Long-term therapy or overdosage can lead to hepatotoxicity. The drug does not increase a person's risk for bleeding.

A 21-year-old female is admitted after taking 25 aspirin tablets at one time. She is admitted with tinnitus, nausea, and vomiting. The health care provider diagnoses the client with salicylate poisoning. What can be used as a treatment for salicylate poisoning? Select all that apply.

• Gastric emptying • Administration of activated charcoal • Life support, if indicated Explanation: Salicylate poisoning is a life-threatening event. Treatment of salicylate poisoning includes gastric emptying, either with syrup of ipecac or gastric lavage; administration of activated charcoal; and life support, if indicated. There is no antidote for salicylate poisoning.