A 45-year-old patient with rheumatoid arthritis is prescribed ketorolac for pain management. Which of the following nursing considerations should be prioritized when administering this medication?
Ensure the patient maintains a diet high in potassium to prevent gastrointestinal distress.
Remind the patient to keep taking NSAIDS intermittently for breakthrough pain relief while on ketorolac
Monitor the patient's renal function and fluid balance even if no signs of impairment are evident.
Advise the patient to take ketorolac on an empty stomach to enhance absorption.
The Correct Answer is C
Rationale:
A. Gastrointestinal distress caused by NSAIDs like ketorolac is primarily due to gastric mucosal irritation, not potassium deficiency. A diet high in potassium does not prevent NSAID-related GI complications. Protective strategies include taking the medication with food or using gastroprotective agents if needed.
B. Ketorolac is a potent NSAID with a high risk of renal toxicity, gastrointestinal bleeding, and cardiovascular effects. It is generally not recommended for long-term or repeated use, and overlapping NSAIDs can increase the risk of adverse effects. The nurse should avoid concurrent NSAIDs unless explicitly prescribed.
C. Ketorolac can cause acute kidney injury, fluid retention, and electrolyte imbalances, even in patients without prior renal issues. Monitoring serum creatinine, BUN, and intake/output is essential to detect early renal compromise. This is especially important in patients with rheumatoid arthritis who may already be at risk due to chronic inflammation or other medications.
D. Taking ketorolac on an empty stomach increases the risk of gastric irritation and ulcers. NSAIDs should typically be taken with food or milk to minimize gastrointestinal adverse effects.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"B"}}
Explanation
Rationale:
Administering factor VIII concentrates is the primary treatment for hemophilia A, as it replaces the deficient clotting factor and helps control bleeding episodes. This intervention directly addresses the underlying coagulation disorder and prevents complications from prolonged bleeding.
Encouraging the child to avoid contact sports reduces the risk of trauma and bleeding episodes. Preventive strategies are essential in managing hemophilia to minimize injury and maintain safety.
Restricting the child from all play is not appropriate because it can negatively impact physical, emotional, and social development. Children with hemophilia should be encouraged to participate in safe, low-impact activities that promote normal growth and well-being.
Screening for potential child abuse is appropriate because frequent bruising and bleeding may mimic signs of abuse. A thorough assessment ensures accurate diagnosis and protects the child while distinguishing between a medical condition and possible external harm.
Correct Answer is A
Explanation
Rationale:
A. Hyperparathyroidism is characterized by overproduction of parathyroid hormone (PTH). PTH stimulates osteoclast activity, which breaks down bone tissue and releases calcium into the bloodstream, leading to hypercalcemia. Other effects of elevated PTH include increased renal calcium reabsorption and enhanced activation of vitamin D, which further increases intestinal calcium absorption.
B. In hyperparathyroidism, PTH promotes conversion of vitamin D to its active form (calcitriol), which enhances intestinal absorption of calcium rather than decreasing it. Low intestinal calcium absorption is more associated with vitamin D deficiency, not primary hyperparathyroidism.
C.PTH actually increases renal calcium reabsorption in the distal tubules. Decreased reabsorption would result in calcium loss and hypocalcemia, which is opposite of what occurs in hyperparathyroidism.
D. PTH is elevated in hyperparathyroidism, not low. Increased calcium excretion (hypercalciuria) can occur secondary to extremely high serum calcium levels, but it is not due to low PTH.
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