Which of the following NSAIDs is used to prevent thrombosis?
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Solution
Aspirin
Aspirin prevents platelet aggregation and thereby has an anticoagulant effect.
To minimize the risk of dyspnea and GI bleeding, OTC ibuprofen is given:
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Solution
With meals
Taking ibuprofen with meals will decrease GI irritation. Ibuprofen is never given IV. Orange juice may promote acidity and increase gastric irritation. Ibuprofen will cause GI upset if given on an empty stomach.
Which of the following groups of clients are most at risk for GI bleeding from the use of NSAIDs?
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Solution
Clients with arthritis
Clients with arthritis are taking the drugs for prolonged periods of time and may take higher doses. Choices A and B are incorrect because the use of NSAIDs with these clients is intermittent. Renal failure is a contraindication for NSAIDs because most of the drug is excreted through the kidneys.
Teaching has been adequate when a client being treated with acetylsalicylic acid states:
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Solution
“If the pills smell like vinegar, I should throw them out.”
Any aspirin should be discarded if a vinegar odor is noticed. Crushing is not recommended for sustained-release preparations. Antacids impair absorption. Taking the medication on an empty stomach will increase GI irritation.
An appropriate nursing diagnosis for clients who are taking NSAIDs and anticoagulants would be which of the following?
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Solution
Risk for injury related to prolonged bleeding time, inhibition of platelet aggregation, and increased risk of GI bleeding.
The nursing diagnosis addresses all the interactions that pose a threat to the client taking both these drugs. Choice B is incorrect because bleeding time is prolonged not decreased when both drugs are used. Choice C is incorrect because platelet aggregation is inhibited not increased when both drugs are used. Choice D is incorrect because thrombocytosis does not occur with use of either drugs.
Which of the following statements about intravenous administration of steroids is true?
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Solution
Steroids administered intravenously can be either in diluted or undiluted form.
IV steroids can either be diluted or given without dilution.
Tom is admitted into the emergency department with an acute spinal cord injury. Methylprednisolone is contraindicated for treatment when the injury:
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Solution
occurred more than 8 hours ago.
Research has shown that steroids are ineffective when given more than 8 hours after acute spinal injury.
Orlando who has been taking steroids for rheumatoid arthritis over several years presents with a compression vertebral fracture. This fracture is due to:
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Solution
the osteoporotic effect of long-term steroid use.
In a client on long-term steroids, a compression vertebral fracture can be assumed to be due to the steroids’ bone-softening effect.
Oral steroids are prescribed on a taper in order to:
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Solution
prevent steroid withdrawal syndrome.
Steroids are tapered off in order to prevent a withdrawal syndrome. Optimal serum levels do not require tapering in order to be maintained. Tapering has nothing to do with drug reliability. Compliance is not dependent on tapering.
As a well-rounded health care provider, you know that corticosteroid therapy is indicated in all of the following conditions except:
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Solution
osteoarthritis
Osteoarthritis is not an indication for corticosteroid therapy. It has an inflammatory component, but the disease is not severe enough to suppress the immune system. Lupus, spinal injury, and rheumatoid arthritis are conditions that require suppression of the immune system in order for the client to survive.