A 70-year-old man with a history of osteoarthritis has been taking Ibuprofen 600 mg three times daily for chronic knee pain. During a routine check-up, his blood pressure is found to be elevated at 160/95 mmHg, up from his usual 135/85 mmHg. Laboratory tests reveal an elevation in his kidney function tests and serum potassium level. Which of the following adverse effects of NSAIDS best explains these findings?
Cardiotoxicity
Nephrotoxicity
Neurotoxicity
Hepatotoxicity
The Correct Answer is B
A. Cardiotoxicity: While NSAIDs can contribute to cardiovascular risks such as hypertension and fluid retention, nephrotoxicity is the more direct explanation for the elevated kidney function tests and potassium level. Cardiotoxicity typically presents with symptoms like heart failure or arrhythmias rather than kidney-related lab abnormalities.
B. Nephrotoxicity: NSAIDs inhibit prostaglandin synthesis, which plays a key role in maintaining renal blood flow, especially in older adults or those with preexisting renal impairment. Chronic NSAID use can reduce glomerular filtration, leading to elevated creatinine, hyperkalemia, and worsening blood pressure control, all of which are evident in this patient.
C. Neurotoxicity: Neurotoxic effects are not commonly associated with NSAID use. Symptoms of neurotoxicity include confusion or seizures, which are not relevant to the clinical findings in this scenario.
D. Hepatotoxicity: NSAID-induced liver injury is rare and would typically present with elevated liver enzymes (AST, ALT), not elevated creatinine or potassium. The current lab findings and blood pressure changes are more consistent with kidney involvement.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. The Cytochrome P-450 Enzyme System: This system plays a major role in drug metabolism, particularly in the liver, but it does not significantly affect drug distribution. Its primary influence is on the biotransformation of drugs into active or inactive metabolites.
B. Renal function: Renal function primarily affects drug excretion. Impaired kidney function can lead to drug accumulation and toxicity but has a minimal direct effect on the distribution of drugs throughout tissues and organs.
C. Gastric pH: Gastric pH influences drug absorption in the gastrointestinal tract, especially for pH-sensitive drugs. However, it plays little to no role in the actual distribution of the drug once it enters systemic circulation.
D. Blood flow: Blood flow is the most significant factor affecting drug distribution. Highly perfused organs like the brain, liver, and kidneys receive drugs more quickly and in higher concentrations than poorly perfused tissues, influencing the onset and intensity of drug action.
Correct Answer is ["150"]
Explanation
Total volume to be infused = 1200 mL
Total infusion time = 8 hours
- Calculate the flow rate in mL per hour (mL/hr):
Flow rate (mL/hr) = Total volume (mL) / Total infusion time (hours)
= 1200 mL / 8 hours
= 150 mL/hr
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