More Questions
More Questions ( 6 Questions)
A nurse is reviewing discharge instructions with a client who will be taking celecoxib (Celebrex) for osteoarthritis. Which statement by the client indicates understanding of the teaching?²
Option A is wrong because the client should not take celecoxib with grapefruit juice to enhance its absorption. Grapefruit juice can interact with celecoxib and increase its blood levels and toxicity . Grapefruit juice inhibits the enzyme CYP3A4, which is involved in the metabolism of celecoxib . By inhibiting CYP3A4, grapefruit juice reduces the clearance of celecoxib and increases its bioavailability and half-life . This can lead to overdose or adverse effects such as gastrointestinal bleeding, renal impairment, or liver damage . The client should avoid grapefruit juice and other foods or drinks that can affect the metabolism of celecoxib .
The statement by the client that indicates understanding of the teaching is B. "I will report any signs of chest pain or shortness of breath to my provider." Celecoxib is a selective COX-2 inhibitor that is used to treat osteoarthritis, a degenerative joint disease that causes pain, stiffness, and reduced mobility . Celecoxib works by inhibiting the enzyme COX-2, which is involved in the synthesis of prostaglandins, thromboxanes, and prostacyclins . These are lipid-derived inflammatory mediators that regulate various physiological processes such as pain, inflammation, blood clotting, and gastric protection .
One of the possible side effects of celecoxib is cardiovascular events, such as myocardial infarction, stroke, or heart failure . Celecoxib can cause cardiovascular events by increasing the risk of thrombosis, vasoconstriction, and hypertension . Celecoxib inhibits the synthesis of prostacyclin, which is a vasodilator and antiplatelet agent that protects the endothelium and prevents thrombus formation . Celecoxib also increases the synthesis of thromboxane A2, which is a vasoconstrictor and proplatelet agent that promotes platelet aggregation and thrombus formation . Celecoxib also reduces the renal excretion of sodium and water, which can increase blood volume and blood pressure . The risk of cardiovascular events is higher in patients who have preexisting cardiovascular disease, diabetes, hypertension, hyperlipidemia, or smoking history , or who use high doses or long-term treatment of celecoxib .
Option C is wrong because the client should not take celecoxib on an empty stomach to avoid nausea. Nausea is a common side effect of celecoxib that can be caused by irritation or ulceration of the gastric mucosa due to decreased mucus production and increased acid secretion . The client should not take celecoxib on an empty stomach, because this can worsen gastric irritation and increase the risk of bleeding or perforation . The client should take celecoxib with food or milk to reduce gastric irritation and report any severe or persistent nausea to the provider . The provider may prescribe antacids, histamine-2 blockers, or proton pump inhibitors to protect the stomach lining and prevent bleeding or perforation .
Option D is wrong because the client should not stop taking celecoxib if they develop a rash or itching. Rash or itching are possible signs of hypersensitivity or allergic reaction to celecoxib , which can be serious or life-threatening. The client should not stop taking celecoxib without consulting with the provider, because this can cause withdrawal symptoms or worsen their condition . The client should monitor for signs of hypersensitivity or allergic reaction such as rash, itching, hives, swelling, difficulty breathing, or anaphylaxis , and report them to the provider as soon as possible . The provider may prescribe antihistamines or corticosteroids to treat the reaction or discontinue celecoxib and switch to another drug.
The statement by the client that indicates understanding of the teaching is B. "I will report any signs of chest pain or shortness of breath to my provider." Celecoxib is a selective COX-2 inhibitor that is used to treat osteoarthritis, a degenerative joint disease that causes pain, stiffness, and reduced mobility . Celecoxib works by inhibiting the enzyme COX-2, which is involved in the synthesis of prostaglandins, thromboxanes, and prostacyclins . These are lipid-derived inflammatory mediators that regulate various physiological processes such as pain, inflammation, blood clotting, and gastric protection .
One of the possible side effects of celecoxib is cardiovascular events, such as myocardial infarction, stroke, or heart failure . Celecoxib can cause cardiovascular events by increasing the risk of thrombosis, vasoconstriction, and hypertension . Celecoxib inhibits the synthesis of prostacyclin, which is a vasodilator and antiplatelet agent that protects the endothelium and prevents thrombus formation . Celecoxib also increases the synthesis of thromboxane A2, which is a vasoconstrictor and proplatelet agent that promotes platelet aggregation and thrombus formation . Celecoxib also reduces the renal excretion of sodium and water, which can increase blood volume and blood pressure . The risk of cardiovascular events is higher in patients who have preexisting cardiovascular disease, diabetes, hypertension, hyperlipidemia, or smoking history , or who use high doses or long-term treatment of celecoxib .
The other options are incorrect because:
Option A is wrong because the client should not take celecoxib with grapefruit juice to enhance its absorption. Grapefruit juice can interact with celecoxib and increase its blood levels and toxicity . Grapefruit juice inhibits the enzyme CYP3A4, which is involved in the metabolism of celecoxib . By inhibiting CYP3A4, grapefruit juice reduces the clearance of celecoxib and increases its bioavailability and half-life . This can lead to overdose or adverse effects such as gastrointestinal bleeding, renal impairment, or liver damage . The client should avoid grapefruit juice and other foods or drinks that can affect the metabolism of celecoxib .
Option C is wrong because the client should not take celecoxib on an empty stomach to avoid nausea. Nausea is a common side effect of celecoxib that can be caused by irritation or ulceration of the gastric mucosa due to decreased mucus production and increased acid secretion . The client should not take celecoxib on an empty stomach, because this can worsen gastric irritation and increase the risk of bleeding or perforation . The client should take celecoxib with food or milk to reduce gastric irritation and report any severe or persistent nausea to the provider . The provider may prescribe antacids, histamine-2 blockers, or proton pump inhibitors to protect the stomach lining and prevent bleeding or perforation .
Option D is wrong because the client should not stop taking celecoxib if they develop a rash or itching. Rash or itching are possible signs of hypersensitivity or allergic reaction to celecoxib , which can be serious or life-threatening. The client should not stop taking celecoxib without consulting with the provider, because this can cause withdrawal symptoms or worsen their condition . The client should monitor for signs of hypersensitivity or allergic reaction such as rash, itching, hives, swelling, difficulty breathing, or anaphylaxis , and report them to the provider as soon as possible . The provider may prescribe antihistamines or corticosteroids to treat the reaction or discontinue celecoxib and switch to another drug.