A client who is taking sildenafil 50 mg PO PRN reports experiencing visual changes to the practical nurse (PN). Which instruction should the PN give to the client?

Choice A reason: Ibuprofen, a nonsteroidal anti-inflammatory drug, inhibits prostaglandins, reducing gastric mucosal protection and increasing GI bleeding risk. Symptoms like melena or hematemesis may occur, especially with prolonged use. Monitoring for bleeding is critical to detect early complications, ensuring timely intervention to prevent severe outcomes.

Choice B reason: While ibuprofen can elevate blood pressure by affecting renal prostaglandins and sodium retention, this is less immediate than GI bleeding risk. Frequent blood pressure monitoring is relevant for long-term use but not the primary concern compared to the acute danger of GI hemorrhage.

Choice C reason: Giving ibuprofen on an empty stomach increases GI irritation, as food buffers gastric acid, reducing ulcer risk. This choice is incorrect, as it contradicts best practice, which recommends taking ibuprofen with food to minimize mucosal damage and bleeding risk.

Choice D reason: Sunblock is irrelevant to ibuprofen’s effects, as it does not cause photosensitivity. This action applies to drugs like tetracyclines, not NSAIDs. Monitoring for GI bleeding is far more critical, as ibuprofen’s primary adverse effect involves the gastrointestinal tract, not skin.

Choice A reason: Montelukast is a leukotriene receptor antagonist that inhibits leukotrienes, mediators of inflammation in allergic responses. By blocking these, it reduces airway inflammation, bronchoconstriction, and mucus production, preventing asthma or allergic rhinitis symptoms. This prophylactic action targets the immune response to allergens, stabilizing respiratory function before symptoms escalate.

Choice B reason: Montelukast does not increase mucus production. Instead, it reduces mucus by inhibiting leukotriene-driven inflammation in the airways. Increased mucus is a symptom of uncontrolled asthma or allergies, which montelukast aims to prevent. This choice is incorrect as it contradicts the drug’s mechanism of reducing inflammatory responses in the lungs.

Choice C reason: Montelukast does not contract respiratory smooth muscles. It prevents bronchoconstriction by blocking leukotrienes, which cause smooth muscle contraction in asthma. By inhibiting this pathway, it promotes airway relaxation, not contraction. This choice is incorrect, as it misrepresents the drug’s role in maintaining open airways.

Choice D reason: Montelukast does not repair damaged lung tissue. Its primary role is to prevent inflammation and bronchoconstriction caused by allergens. Lung tissue repair involves other physiological processes, not influenced by montelukast. This choice is incorrect, as it falsely attributes tissue regeneration to a drug focused on immune modulation.