Prep you Chapter 16

What conditions are salicylates are effective in managing? (Select all that apply.)

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

A male client taking penicillamine calls the clinic and tells the nurse that he is seeing double and his eyes are "drooping closed." What is the best response by the nurse?

"Do not take any more of the medication and come into the clinic immediately to see the health care provider."

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."

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."

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?

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."

What should a nurse recognize as a property of ibuprofen/Motrin? (Select all that apply.)

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 for a medication history.

A healthcare provider has recommended the use of acetaminophen to treat the client's pain. What should the nurse teach the client about safe and effective use of acetaminophen?

Avoid taking more than 3000 mg in any 24-hour period

A patient with arthritis is on NSAID therapy. What should be evaluated by the nurse to determine the effectiveness of NSAID therapy?

Better mobility

A client is receiving anakinra as treatment for arthritis. The nurse understands that this drug acts in which manner?

Blocks interleukin-1

A student nurse asks the nurse why acetaminophen and 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.

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

Gold compounds are commonly used as first-line therapy for the treatment of rheumatoid arthritis.

FALSE

A patient is admitted to the emergency department with a suspected overdose of acetaminophen (Tylenol). What adverse effect is most common in acute or chronic overdose of acetaminophen (Tylenol)?

Hepatotoxicity

Which conditions would contraindicate the use of gold salts? Select all that apply.

Hypertension Uncontrolled diabetes Blood dyscrasias

A 60-year-old patient with rheumatoid arthritis visits the health care facility for a regular checkup. The patient informs the nurse that the patient has been using an over-the-counter NSAID for the last few days. Why should the nurse caution the patient against the use of NSAIDs on a long-term basis?

Increased risk of GI bleeding

What conditions are salicylates are effective in managing? (Select all that apply.)

Inflammation Pain Fever

The client is taking NSAIDs for pain. The nurse explains to the client that NSAIDs act by which actions?

Inhibiting the synthesis of prostaglandins

Which NSAID should the nurse know are NOT used to treat osteoarthritis or rheumatoid arthritis? (Select all that apply.)

Ketorolac (Toradol) Mefenamic (Ponstel)

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

A nurse suspects that a client is experiencing salicylism. What would the nurse assess for?

Mental confusion

A client is receiving auranofin as treatment for rheumatoid arthritis. The nurse should expect this drug to be given by which route?

Oral

When acetylsalicylic acid is administered in low doses, it blocks the synthesis of thromboxane A2. What physiologic effect results from this action?

Platelet aggregation is inhibited.

An 11-year-old client is having a cavity filled in the left mandibular first molar. The health care provider has prescribed aspirin for pain relief after the procedure. The nurse discovers upon assessment that the child is suffering from a flulike illness. The nurse contacts the health care provider about the prescribed medication for pain. What is the risk if aspirin is administered to this client?

Reye syndrome

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

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.

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 has hepatitis C and abuses alcohol

A patient has been diagnosed with rheumatoid arthritis and is experiencing pain and decreased mobility. Etanercept has been proposed as possible treatment option. Which characteristic of this patient would likely preclude the use of etanercept?

The patient has chronic osteomyelitis resulting from a diabetic foot ulcer.

A nurse should recognize which signs in a client with salicylism? (Select all that apply.)

Tinnitus Sweating Mental confusion

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

To inhibit platelet aggregation

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?

acetylsalicylic acid

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.

Prior to administering NSAIDs, the nurse asks the client about an allergy to:

aspirin

Which NSAID appears to work by specifically inhibiting cyclooxygenase-2 (COX-2) without inhibiting cyclooxygenase-1 (COX-1)?

celecoxib

The nurse knows that acetaminophen should not be used in older adults with which condition?

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-2

A client is ordered to receive an 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?

decrease body temperature.

A nurse is reviewing the medical record of a client who is prescribed NSAID therapy. The nurse determines that the drug would be contraindicated for the client if a hypersensitivity to which drug was found?

aspirin

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?

hepatotoxicity

The nurse is aware that aspirin not only lowers the client's fever but can also reduce the pain the client is experiencing by:

inhibiting the production of prostaglandins.

A nurse is preparing to teach a client about the adverse effects of prescribed NSAID therapy. The nurse plans to focus on the most common adverse reactions caused by this group of drugs. Which effects would the nurse include as being involved?

stomach

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

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

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

Celecoxib

A 25-year-old woman with rheumatoid arthritis is being treated with acetaminophen and salicylates. The health care provider has switched her medication regimen to include DMARDs. What is the advantage of DMARDs over salicylates?

DMARDs can arrest the progression of rheumatoid arthritis.

A client with rheumatoid arthritis is relieved to have less pain and inflammation since a change in medications. The nurse is aware that the new medication inhibits phagocytosis and prevents the release of lysosomal enzymes. What medication classification is this client receiving?

Gold salts

The nurse is administering chrysotherapy to a patient with rheumatoid arthritis. What drug will the nurse be administering?

Gold salts

The nurse would question the health care provider who prescribed NSAIDs for which client?

The client diagnosed with peptic ulcers

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?

acetaminophen

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.

A 66-year-old woman has experienced a significant decline in her quality of life as a result of worsening rheumatoid arthritis. Her physician has prescribed etanercept and the nurse is responsible for facilitating this new aspect of the patient's drug regimen. This will involve the administration of:

weekly subcutaneous injections.