Nonsteroidal anti-inflammatory drugs (NSAIDs)
Nonsteroidal anti-inflammatory drugs (NSAIDs) ( 4 Questions)
A nurse is preparing to administer ketorolac (Toradol), a nonselective COX inhibitor, to a client who has moderate to severe pain after surgery. What are some of the nursing considerations for this drug?
It should be given orally with food or milk to minimize gastrointestinal irritation: This is because ketorolac can cause gastrointestinal effects such as nausea, vomiting, ulceration, bleeding, and perforation by blocking the production of prostaglandins that protect the gastric mucosa from acid and pepsin²³. The nurse should advise the client to take ketorolac with food or milk, avoid alcohol and tobacco, report any signs of gastrointestinal bleeding (such as black or tarry stools, abdominal pain, vomiting blood), and use the lowest effective dose for the shortest duration possible²³.
It should be given intravenously slowly over 15 to 30 minutes to prevent hypotension or thrombophlebitis: This is because ketorolac can cause hypotension by blocking the production of prostaglandins that regulate blood pressure and vascular tone² . It can also cause thrombophlebitis by irritating the vein wall and causing inflammation and clot formation² . The nurse should monitor the client's blood pressure and infusion site during and after the administration of ketorolac and report any signs of hypotension (such as dizziness, fainting, blurred vision) or thrombophlebitis (such as redness, swelling, pain, warmth) to the doctor² .
It should be given for short-term use only (up to 5 days) to avoid renal impairment or gastrointestinal bleeding: This is because ketorolac can cause renal impairment by blocking the production of prostaglandins that maintain renal blood flow, glomerular filtration rate, sodium excretion, and water balance² . It can also cause gastrointestinal bleeding by blocking the production of prostaglandins that inhibit platelet aggregation and promote hemostasis²³. The risk of these effects is higher in those with preexisting renal impairment, heart failure, liver cirrhosis, dehydration, or hypovolemia, and those who use diuretics or anticoagulants²³ . The nurse should monitor the client's fluid intake and output, body weight, electrolytes, and renal function tests, and report any signs of renal dysfunction (such as oliguria, anuria, edema) or gastrointestinal bleeding (such as black or tarry stools, abdominal pain, vomiting blood) to the doctor²³ .
This is because ketorolac can cause gastrointestinal, renal, and cardiovascular effects as a result of its nonselective inhibition of cyclooxygenase (COX) enzymes². COX enzymes are responsible for producing prostaglandins that have different functions in different tissues. By blocking both COX-1 and COX-2 enzymes, ketorolac can interfere with the protective, regulatory, and homeostatic roles of prostaglandins in various organs². Therefore, the nurse should consider the following points when administering this drug:
This is because ketorolac can cause gastrointestinal, renal, and cardiovascular effects as a result of its nonselective inhibition of cyclooxygenase (COX) enzymes². COX enzymes are responsible for producing prostaglandins that have different functions in different tissues. By blocking both COX-1 and COX-2 enzymes, ketorolac can interfere with the protective, regulatory, and homeostatic roles of prostaglandins in various organs². Therefore, the nurse should consider the following points when administering this drug:
A. ssas
It should be given orally with food or milk to minimize gastrointestinal irritation: This is because ketorolac can cause gastrointestinal effects such as nausea, vomiting, ulceration, bleeding, and perforation by blocking the production of prostaglandins that protect the gastric mucosa from acid and pepsin²³. The nurse should advise the client to take ketorolac with food or milk, avoid alcohol and tobacco, report any signs of gastrointestinal bleeding (such as black or tarry stools, abdominal pain, vomiting blood), and use the lowest effective dose for the shortest duration possible²³.
B. asdasd
It should be given intravenously slowly over 15 to 30 minutes to prevent hypotension or thrombophlebitis: This is because ketorolac can cause hypotension by blocking the production of prostaglandins that regulate blood pressure and vascular tone² . It can also cause thrombophlebitis by irritating the vein wall and causing inflammation and clot formation² . The nurse should monitor the client's blood pressure and infusion site during and after the administration of ketorolac and report any signs of hypotension (such as dizziness, fainting, blurred vision) or thrombophlebitis (such as redness, swelling, pain, warmth) to the doctor² .
C. asfdeaf
It should be given for short-term use only (up to 5 days) to avoid renal impairment or gastrointestinal bleeding: This is because ketorolac can cause renal impairment by blocking the production of prostaglandins that maintain renal blood flow, glomerular filtration rate, sodium excretion, and water balance² . It can also cause gastrointestinal bleeding by blocking the production of prostaglandins that inhibit platelet aggregation and promote hemostasis²³. The risk of these effects is higher in those with preexisting renal impairment, heart failure, liver cirrhosis, dehydration, or hypovolemia, and those who use diuretics or anticoagulants²³ . The nurse should monitor the client's fluid intake and output, body weight, electrolytes, and renal function tests, and report any signs of renal dysfunction (such as oliguria, anuria, edema) or gastrointestinal bleeding (such as black or tarry stools, abdominal pain, vomiting blood) to the doctor²³ .