A nurse is caring for a client who has a sickle cell crisis and is receiving morphine via patient-controlled analgesia (PCA) pump.

Which assessment finding indicates that the PCA pump is effective?

The correct answer is choice C) Chest pain.

This is because chest pain can be a sign of a serious cardiovascular event, such as a heart attack or stroke, which can be fatal.

Celecoxib is a nonsteroidal anti-inflammatory drug (NSAID) that belongs to the class of cyclooxygenase-2 (COX-2) inhibitors.These drugs can increase the risk of cardiovascular thrombotic events, especially in patients with a history of heart disease or risk factors.

Therefore, the nurse should instruct the client to report chest pain immediately and seek emergency medical attention.

Choice A) Constipation is wrong because it is not a common or serious side effect of celecoxib.

Constipation can be caused by many factors, such as diet, dehydration, lack of exercise, or other medications.It can be managed by increasing fluid and fiber intake, using laxatives or stool softeners as needed, and consulting a doctor if it persists or worsens.

Choice B) Nausea is wrong because it is a common but mild side effect of celecoxib that usually goes away with time or can be reduced by taking the medication with food or milk.

Nausea is not a sign of a serious adverse reaction and does not require immediate medical attention.

Choice D) Headache is wrong because it is also a common but mild side effect of celecoxib that can be treated with over-the-counter pain relievers, such as acetaminophen or ibuprofen.

However, the client should avoid taking aspirin or other NSAIDs with celecoxib, as this can increase the risk of gastrointestinal bleeding and ulcers

The correct answer is choice A. Hepatic necrosis.Acetaminophen (APAP) is a common cause of drug-induced liver injury and can lead to hepatic necrosis, especially in patients who have chronic hepatitis C.APAP is metabolized by the liver and produces a toxic intermediate called N-acetyl-p-benzoquinone imine (NAPQI), which can deplete glutathione and damage hepatocytes.Patients who have chronic hepatitis C may have reduced glutathione levels and increased oxidative stress, making them more susceptible to APAP toxicity.

Choice B. Pulmonary fibrosis is wrong because APAP does not cause pulmonary fibrosis.

Pulmonary fibrosis is a chronic lung disease that involves scarring of the lung tissue and impaired gas exchange.Some drugs that can cause pulmonary fibrosis are amiodarone, bleomycin, methotrexate and nitrofurantoin.

Choice C. Pancreatitis is wrong because APAP does not cause pancreatitis.

Pancreatitis is an inflammation of the pancreas that can result from gallstones, alcohol abuse, hypertriglyceridemia, hypercalcemia, infections, trauma or certain medications.

Some drugs that can cause pancreatitis are azathioprine, valproic acid, didanosine and pentamidine.

Choice D. Cardiac dysrhythmias is wrong because APAP does not cause cardiac dysrhythmias.

Cardiac dysrhythmias are abnormal heart rhythms that can result from electrolyte imbalances, ischemia, myocardial infarction, heart failure, congenital defects or certain medications.

Some drugs that can cause cardiac dysrhythmias are digoxin, quinidine, sotalol and erythromycin.