A nurse is teaching a client who has chronic pain about nonpharmacological pain management techniques.

Which of the following statements by the client indicates an understanding of the teaching? (Select all that apply.).

The correct answer is choice A, B, C, and D.Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that has anti-inflammatory, analgesic, and antipyretic effects.It works by inhibiting the synthesis of prostaglandins, which are involved in inflammation, pain, and fever.However, ibuprofen can also cause adverse effects such as gastric irritation, bleeding complications, renal impairment, and hypersensitivity reactions.

Therefore, the nurse should instruct the client to:

• Take ibuprofen with food or milk to prevent gastric irritation.This will reduce the direct contact of the drug with the stomach lining and decrease the risk of ulcers and bleeding.

• Drink at least 2 liters of fluid per day to prevent renal impairment.This will help maintain adequate hydration and renal perfusion and prevent the accumulation of ibuprofen in the kidneys.

• Avoid alcohol and other NSAIDs to prevent bleeding complications.Alcohol and other NSAIDs can increase the risk of gastric bleeding by interfering with the protective effects of prostaglandins on the stomach mucosa.

• Report any signs of hypersensitivity such as rash, itching, or wheezing.These may indicate an allergic reaction to ibuprofen that can be serious or life-threatening.

Choice E is wrong because ibuprofen does not affect blood pressure significantly.However, some other NSAIDs such as celecoxib may increase the risk of cardiovascular events such as thrombosis, myocardial infarction, and stroke.Therefore, clients with hypertension or cardiovascular disease should use NSAIDs with caution and monitor their blood pressure regularly.

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