Adverse effects of NSAIDs
Adverse effects of NSAIDs ( 3 Questions)
A nurse is evaluating a client who has fever and is receiving ibuprofen (Motrin), a nonselective COX inhibitor. What are some of the outcomes that indicate the effectiveness of the therapy?
Ibuprofen is a nonselective COX inhibitor, which means it blocks the production of prostaglandins, which are involved in inflammation, pain, fever, and blood clotting. Ibuprofen has antipyretic (fever-reducing) effects by inhibiting the synthesis of prostaglandins in the hypothalamus, the part of the brain that regulates body temperature . Ibuprofen can lower fever by 1 to 2°C within 2 to 4 hours of administration . The normal body temperature range is 36.5 to 37.5°C (97.7 to 99.5°F).
Decreased inflammation, pain, and swelling are not outcomes that indicate the effectiveness of ibuprofen therapy for fever. These are outcomes that indicate the effectiveness of ibuprofen therapy for inflammation and pain, which are other indications for ibuprofen. Ibuprofen has anti-inflammatory and analgesic effects by blocking the production of prostaglandins that mediate inflammation and pain . However, these effects are not relevant for fever management.
Decreased risk of gastrointestinal bleeding and ulceration are not outcomes that indicate the effectiveness of ibuprofen therapy for fever. These are outcomes that indicate the prevention or reduction of adverse effects of ibuprofen therapy. Ibuprofen has gastrointestinal effects such as nausea, vomiting, ulceration, bleeding, and perforation by blocking the production of prostaglandins that protect the stomach lining from acid and pepsin . These effects are more likely to occur in patients with a history of peptic ulcer disease or gastrointestinal bleeding or in patients who take high doses or long-term use of ibuprofen. The nurse should monitor the client for signs and symptoms of gastrointestinal bleeding and ulceration such as abdominal pain, black or bloody stools, hematemesis (vomiting blood), melena (dark tarry stools), anemia (low red blood cell count), or hypotension (low blood pressure). The nurse should also advise the client to take ibuprofen with food or milk to reduce gastric irritation and to avoid alcohol or other NSAIDs that may increase the risk of gastrointestinal bleeding and ulceration.
Decreased risk of hepatotoxicity and liver impairment are not outcomes that indicate the effectiveness of ibuprofen therapy for fever. These are outcomes that indicate the prevention or reduction of adverse effects of ibuprofen therapy. Ibuprofen has hepatic effects such as elevated liver enzymes, jaundice (yellowing of skin or eyes), hepatitis (inflammation of liver), and liver failure by affecting hepatic function and metabolism . These effects are rare but serious and may occur in patients with hepatic impairment or risk factors for hepatic toxicity such as alcoholism or concurrent use of other hepatotoxic drugs. The nurse should monitor the client's liver function tests and report any abnormal results or signs and symptoms of liver injury such as nausea, vomiting, anorexia (loss of appetite), fatigue
Ibuprofen is a nonselective COX inhibitor, which means it blocks the production of prostaglandins, which are involved in inflammation, pain, fever, and blood clotting. Ibuprofen has antipyretic (fever-reducing) effects by inhibiting the synthesis of prostaglandins in the hypothalamus, the part of the brain that regulates body temperature . Ibuprofen can lower fever by 1 to 2°C within 2 to 4 hours of administration . The normal body temperature range is 36.5 to 37.5°C (97.7 to 99.5°F).
The other options are incorrect because:
B. Decreased inflammation, pain, and swelling are not outcomes that indicate the effectiveness of ibuprofen therapy for fever. These are outcomes that indicate the effectiveness of ibuprofen therapy for inflammation and pain, which are other indications for ibuprofen. Ibuprofen has anti-inflammatory and analgesic effects by blocking the production of prostaglandins that mediate inflammation and pain . However, these effects are not relevant for fever management.
C. Decreased risk of gastrointestinal bleeding and ulceration are not outcomes that indicate the effectiveness of ibuprofen therapy for fever. These are outcomes that indicate the prevention or reduction of adverse effects of ibuprofen therapy. Ibuprofen has gastrointestinal effects such as nausea, vomiting, ulceration, bleeding, and perforation by blocking the production of prostaglandins that protect the stomach lining from acid and pepsin . These effects are more likely to occur in patients with a history of peptic ulcer disease or gastrointestinal bleeding or in patients who take high doses or long-term use of ibuprofen. The nurse should monitor the client for signs and symptoms of gastrointestinal bleeding and ulceration such as abdominal pain, black or bloody stools, hematemesis (vomiting blood), melena (dark tarry stools), anemia (low red blood cell count), or hypotension (low blood pressure). The nurse should also advise the client to take ibuprofen with food or milk to reduce gastric irritation and to avoid alcohol or other NSAIDs that may increase the risk of gastrointestinal bleeding and ulceration.
D. Decreased risk of hepatotoxicity and liver impairment are not outcomes that indicate the effectiveness of ibuprofen therapy for fever. These are outcomes that indicate the prevention or reduction of adverse effects of ibuprofen therapy. Ibuprofen has hepatic effects such as elevated liver enzymes, jaundice (yellowing of skin or eyes), hepatitis (inflammation of liver), and liver failure by affecting hepatic function and metabolism . These effects are rare but serious and may occur in patients with hepatic impairment or risk factors for hepatic toxicity such as alcoholism or concurrent use of other hepatotoxic drugs. The nurse should monitor the client's liver function tests and report any abnormal results or signs and symptoms of liver injury such as nausea, vomiting, anorexia (loss of appetite), fatigue