A nurse is administering aspirin (ASA), a nonselective COX inhibitor, to a client who has rheumatoid arthritis. What are some of the specific indications of aspirin in this condition?
It reduces inflammation, pain, fever, and platelet aggregation by blocking the production of prostaglandins.
It prevents cardiovascular events such as myocardial infarction and stroke by inhibiting platelet aggregation and thromboxane synthesis.
It treats gouty arthritis by inhibiting the enzyme xanthine oxidase and reducing the production of uric acid.
It induces labor by stimulating uterine contractions and cervical ripening by blocking the production of prostaglandins.
The Correct Answer is A
According to various sources, aspirin is a nonselective COX inhibitor that blocks the production of prostaglandins that are involved in inflammation, pain, fever, and platelet aggregation¹²³⁴. Aspirin is used to relieve the symptoms of rheumatoid arthritis (RA), such as joint swelling, stiffness, and pain¹²³⁴. Aspirin also has antiplatelet effects that can prevent cardiovascular events, such as myocardial infarction and stroke, in patients with RA who have an increased risk of atherosclerosis²³. However, aspirin does not modify the course or progression of RA, and it may cause gastrointestinal bleeding, ulceration, and perforation, as well as hypersensitivity reactions, renal impairment, and Reye's syndrome¹²³⁴. Therefore, aspirin should be used with caution and under medical supervision in patients with RA.
The other options are incorrect because:
B. It prevents cardiovascular events such as myocardial infarction and stroke by inhibiting platelet aggregation and thromboxane synthesis.
This option is wrong because it is not a specific indication of aspirin in rheumatoid arthritis, but a general indication of aspirin in patients with or at risk of cardiovascular disease . Aspirin can prevent cardiovascular events by inhibiting platelet aggregation and thromboxane synthesis, but this effect is not related to the treatment of rheumatoid arthritis symptoms, such as inflammation, pain, and fever . However, aspirin may have a secondary benefit of reducing the cardiovascular risk in patients with rheumatoid arthritis who have an increased risk of atherosclerosis .
C. It treats gouty arthritis by inhibiting the enzyme xanthine oxidase and reducing the production of uric acid.
This option is wrong because it describes the mechanism of action and indication of allopurinol, not aspirin . Allopurinol is a drug that treats gouty arthritis by inhibiting the enzyme xanthine oxidase and reducing the production of uric acid, which causes inflammation and pain in the joints . Aspirin does not inhibit xanthine oxidase or reduce uric acid levels, and it is not used to treat gouty arthritis . In fact, aspirin may worsen gouty arthritis by interfering with the renal excretion of uric acid and increasing its concentration in the blood .
D. It induces labor by stimulating uterine contractions and cervical ripening by blocking the production of prostaglandins.
This option is wrong because it describes the mechanism of action and indication of misoprostol, not aspirin . Misoprostol is a synthetic prostaglandin that induces labor by stimulating uterine contractions and cervical ripening . Aspirin does not induce labor, but rather blocks the production of prostaglandins that are involved in inflammation, pain, fever, and platelet aggregation
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Correct Answer is A
Explanation
According to various sources, aspirin is a nonselective COX inhibitor that blocks the production of prostaglandins that are involved in inflammation, pain, fever, and platelet aggregation¹²³⁴. Aspirin is used to relieve the symptoms of rheumatoid arthritis (RA), such as joint swelling, stiffness, and pain¹²³⁴. Aspirin also has antiplatelet effects that can prevent cardiovascular events, such as myocardial infarction and stroke, in patients with RA who have an increased risk of atherosclerosis²³. However, aspirin does not modify the course or progression of RA, and it may cause gastrointestinal bleeding, ulceration, and perforation, as well as hypersensitivity reactions, renal impairment, and Reye's syndrome¹²³⁴. Therefore, aspirin should be used with caution and under medical supervision in patients with RA.
The other options are incorrect because:
B. It prevents cardiovascular events such as myocardial infarction and stroke by inhibiting platelet aggregation and thromboxane synthesis.
This option is wrong because it is not a specific indication of aspirin in rheumatoid arthritis, but a general indication of aspirin in patients with or at risk of cardiovascular disease . Aspirin can prevent cardiovascular events by inhibiting platelet aggregation and thromboxane synthesis, but this effect is not related to the treatment of rheumatoid arthritis symptoms, such as inflammation, pain, and fever . However, aspirin may have a secondary benefit of reducing the cardiovascular risk in patients with rheumatoid arthritis who have an increased risk of atherosclerosis .
C. It treats gouty arthritis by inhibiting the enzyme xanthine oxidase and reducing the production of uric acid.
This option is wrong because it describes the mechanism of action and indication of allopurinol, not aspirin . Allopurinol is a drug that treats gouty arthritis by inhibiting the enzyme xanthine oxidase and reducing the production of uric acid, which causes inflammation and pain in the joints . Aspirin does not inhibit xanthine oxidase or reduce uric acid levels, and it is not used to treat gouty arthritis . In fact, aspirin may worsen gouty arthritis by interfering with the renal excretion of uric acid and increasing its concentration in the blood .
D. It induces labor by stimulating uterine contractions and cervical ripening by blocking the production of prostaglandins.
This option is wrong because it describes the mechanism of action and indication of misoprostol, not aspirin . Misoprostol is a synthetic prostaglandin that induces labor by stimulating uterine contractions and cervical ripening . Aspirin does not induce labor, but rather blocks the production of prostaglandins that are involved in inflammation, pain, fever, and platelet aggregation
Correct Answer is A
Explanation
Acetaminophen (Tylenol) is commonly used to reduce fever. Fever is an elevated body temperature, and one of the main goals of using acetaminophen is to lower the body temperature back to the normal range. Therefore, a decreased temperature within the normal range would indicate the effectiveness of the therapy in reducing fever.
Options B, C, and D, are not directly related to the use of acetaminophen.
B.
Option B refers to the effects of NSAIDs (nonsteroidal anti-inflammatory drugs) in general, which include reducing inflammation, pain, and swelling. Acetaminophen is not primarily an anti-inflammatory drug, so it may not have significant effects on inflammation, pain, or swelling.
C.
Option C refers to the gastrointestinal side effects associated with NSAIDs, such as bleeding and ulceration. Acetaminophen is generally considered safer for the gastrointestinal system compared to NSAIDs, but it does not specifically decrease the risk of gastrointestinal bleeding and ulceration.
D.
Option D refers to the potential adverse effects of acetaminophen on the liver, such as hepatotoxicity and liver impairment. While these are possible risks associated with acetaminophen, decreased risk is not an outcome that directly indicates the effectiveness of the therapy. Monitoring liver function is important when using acetaminophen, especially at higher doses or with prolonged use, but it does not serve as an indicator of the therapy's effectiveness in reducing fever.
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