A client has a new prescription for diclofenac, a nonsteroidal antiinflammatory drug (NSAID). Which information in the client's history is of greatest concern to the nurse in monitoring the client's response to this medication?
Migraine headaches.
Chronic alcoholism.
Osteoarthritis.
Type 2 diabetes mellitus.
The Correct Answer is B
A) Migraine headaches: While migraine headaches are significant for overall health management, they are less directly related to the risks associated with NSAID use compared to other conditions. Migraines do not typically influence the safety profile of NSAIDs.
B) Chronic alcoholism: Chronic alcoholism is a major concern because it significantly increases the risk of gastrointestinal complications with NSAID use. NSAIDs can cause gastric irritation, bleeding, and ulcers, and alcohol can exacerbate these risks, leading to severe gastrointestinal issues or liver damage.
C) Osteoarthritis: Osteoarthritis is a common indication for NSAID use and, therefore, does not pose an additional risk specific to the medication. NSAIDs are often prescribed to manage pain and inflammation associated with osteoarthritis.
D) Type 2 diabetes mellitus: Although diabetes mellitus requires careful management, it does not directly increase the risk of NSAID-related complications. However, clients with diabetes need to be monitored for overall health and medication effects, but chronic alcoholism poses a more immediate risk for NSAID use.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Request a prescription to change the route of administration and use the available heparin:
Low molecular weight heparin (LMWH) and unfractionated heparin (UFH) are not interchangeable. LMWH is usually administered subcutaneously, whereas UFH is administered intravenously for acute situations. Changing the route of administration without a new prescription would not be appropriate.
B. Advise the pharmacy of the need to deliver a vial of heparin to the nursing unit immediately:
Since the prescription is for intravenous heparin and the available syringes are of LMWH (which is not suitable for IV use), it is essential to contact the pharmacy to provide the correct formulation. Immediate action ensures that the client receives the correct medication promptly.
C. Calculate and administer the equivalent dose of the available low molecular weight heparin:
Calculating and administering LMWH instead of UFH is inappropriate because they are different types of heparin with different indications, dosing regimens, and routes of administration. Using LMWH for an IV prescription could result in ineffective treatment or complications.
D. Dilute the available heparin in 250 mL of normal saline solution prior to IV administration:
LMWH should not be diluted or used in place of UFH for IV administration. This action is incorrect because the available medication is not suitable for the prescribed route and dose. The proper medication needs to be obtained from the pharmacy.
Correct Answer is B
Explanation
A. High density lipoprotein (HDL):
HDL levels are important for cardiovascular health as higher levels are associated with a lower risk of coronary artery disease. However, atorvastatin primarily targets LDL levels. While increasing HDL is beneficial, it is not the primary measure of atorvastatin's effectiveness.
B. Low density lipoprotein (LDL):
Atorvastatin is a statin medication used to lower LDL cholesterol levels, which is a major risk factor for coronary artery disease. A decrease in LDL levels indicates that the medication is having its desired effect, reducing the risk of cardiovascular events.
C. Creatine phosphokinase (CK):
CK levels are monitored to assess muscle damage or side effects related to statin use, such as rhabdomyolysis. While important for safety monitoring, changes in CK levels do not directly reflect the effectiveness of atorvastatin in managing cholesterol levels.
D. Prothrombin time (PT):
PT is used to evaluate blood clotting ability and is not directly related to the effectiveness of atorvastatin. It is more relevant for monitoring anticoagulant therapy rather than statin therapy for cholesterol management.
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