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
It should be given intravenously slowly over 15 to 30 minutes to prevent hypotension or thrombophlebitis
It should be given for short-term use only (up to 5 days) to avoid renal impairment or gastrointestinal bleeding
All of the above
The Correct Answer is D
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 .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
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 .
Correct Answer is A
Explanation
According to various sources, aspirin is a nonselective COX inhibitor that blocks the production of prostaglandins that are involved in inflammation, pain, fever, and platelet aggregation¹²³⁴. Aspirin is used to relieve the symptoms of rheumatoid arthritis (RA), such as joint swelling, stiffness, and pain¹²³⁴. Aspirin also has antiplatelet effects that can prevent cardiovascular events, such as myocardial infarction and stroke, in patients with RA who have an increased risk of atherosclerosis²³. However, aspirin does not modify the course or progression of RA, and it may cause gastrointestinal bleeding, ulceration, and perforation, as well as hypersensitivity reactions, renal impairment, and Reye's syndrome¹²³⁴. Therefore, aspirin should be used with caution and under medical supervision in patients with RA.
The other options are incorrect because:
B. It prevents cardiovascular events such as myocardial infarction and stroke by inhibiting platelet aggregation and thromboxane synthesis.
This option is wrong because it is not a specific indication of aspirin in rheumatoid arthritis, but a general indication of aspirin in patients with or at risk of cardiovascular disease . Aspirin can prevent cardiovascular events by inhibiting platelet aggregation and thromboxane synthesis, but this effect is not related to the treatment of rheumatoid arthritis symptoms, such as inflammation, pain, and fever . However, aspirin may have a secondary benefit of reducing the cardiovascular risk in patients with rheumatoid arthritis who have an increased risk of atherosclerosis .
C. It treats gouty arthritis by inhibiting the enzyme xanthine oxidase and reducing the production of uric acid.
This option is wrong because it describes the mechanism of action and indication of allopurinol, not aspirin . Allopurinol is a drug that treats gouty arthritis by inhibiting the enzyme xanthine oxidase and reducing the production of uric acid, which causes inflammation and pain in the joints . Aspirin does not inhibit xanthine oxidase or reduce uric acid levels, and it is not used to treat gouty arthritis . In fact, aspirin may worsen gouty arthritis by interfering with the renal excretion of uric acid and increasing its concentration in the blood .
D. It induces labor by stimulating uterine contractions and cervical ripening by blocking the production of prostaglandins.
This option is wrong because it describes the mechanism of action and indication of misoprostol, not aspirin . Misoprostol is a synthetic prostaglandin that induces labor by stimulating uterine contractions and cervical ripening . Aspirin does not induce labor, but rather blocks the production of prostaglandins that are involved in inflammation, pain, fever, and platelet aggregation
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.