A nurse educator is discussing National Patient Safety Goals (NPSG) at orientation for new nurse graduates.

For each potential intervention aimed at addressing various National Patient Safety Goals (NPSG), click to specify which intervention is appropriate for each goal.

A. Bone pain. Celecoxib is a selective COX-2 inhibitor that helps reduce pain and inflammation associated with osteoarthritis. It does not commonly cause bone pain. If a client experiences new or worsening bone pain, it may be due to the progression of osteoarthritis or another underlying condition rather than the medication.
B. Polyuria. Increased urination is not a known adverse effect of celecoxib. While NSAIDs can impact kidney function, they are more commonly associated with fluid retention and potential kidney impairment rather than excessive urination. Clients should be monitored for signs of kidney dysfunction, such as decreased urine output or swelling.
C. Black, tarry stools. Celecoxib, like other NSAIDs, increases the risk of gastrointestinal bleeding and ulcer formation. Black, tarry stools indicate the presence of digested blood from an upper GI bleed, which requires immediate medical attention. Clients taking celecoxib should report any signs of gastrointestinal bleeding, such as dark stools or vomiting blood.
D. Dry mouth. Celecoxib is not commonly associated with dry mouth. While some medications can cause decreased saliva production, celecoxib’s primary concerns are cardiovascular risks, kidney impairment, and gastrointestinal complications rather than significant effects on oral hydration.

Weight: The client has continued to lose weight (a total of 20 lb now), which suggests that their appetite and nutritional intake have not improved. This is a concern rather than a sign of progress, as poor nutrition can further impact emotional and physical well-being.

Sleep: The client reports sleeping longer, which suggests some improvement compared to the severe insomnia reported in the initial visit. While they still wake up feeling exhausted and have bad dreams, the ability to sleep for a longer duration is a step toward better rest.

Future plans: The client has made a significant decision about their teaching position by resigning. Although this may seem like a setback, it indicates that they are actively making decisions about their future rather than feeling stuck. Additionally, they report that they are thinking about seeking grief counseling or joining a support group, which shows willingness to seek help and engage in the healing process.

Anger: There is no mention of a reduction in anger. In the initial visit, the client expressed strong emotions about the unfairness of the loss, and the second visit does not indicate that these feelings have lessened or been processed in a healthy way.

Guilt: The notes do not indicate that the client has resolved their guilt over their partner’s death. The initial report showed strong self-blame, and without a statement suggesting a shift in perspective, guilt remains a barrier to healing.

Isolation: The client continues to describe limited social support and feels disconnected from friends and family. Although their adult children check in, the client still expresses a sense of emotional distance rather than re-engaging with relationships. Without active efforts to reconnect, isolation remains a concern rather than a sign of progress.