A nurse is discussing how beta blockers work to decrease blood pressure with a nursing student. Which statement by the student indicates a need for further teaching?

Choice A reason is that Zithromax (azithromycin) is not linked to cancer in women; this is inaccurate. QT prolongation is a known risk, especially in elderly patients with cardiac issues, so this is incorrect.

Choice B reason: Azithromycin can prolong the QT interval, risking arrhythmias, particularly in older women with heart rhythm issues. This explains the different prescribing, making it the correct choice.

Choice C reason: Zithromax’s effectiveness is not gender-specific; efficacy depends on the infection, not sex. The cardiac risk is the concern, so this is incorrect for the explanation.

Choice D reason: Cost or insurance is irrelevant to the medical decision. QT prolongation risk in this patient’s profile drives the choice, so this is incorrect.

Choice A reason: Increasing aspirin dosage without medical guidance risks toxicity, including gastrointestinal bleeding and ulceration, as aspirin inhibits COX enzymes, reducing prostaglandin production. Prostaglandins mediate pain and inflammation, but excessive inhibition can damage the stomach lining. This approach is unsafe and not recommended for managing menstrual cramps effectively, as it may exacerbate adverse effects without ensuring better pain relief.

Choice B reason: First-generation NSAIDs, like ibuprofen, are more effective for menstrual cramps due to their stronger inhibition of COX-1 and COX-2 enzymes, which reduce prostaglandin synthesis responsible for uterine contractions and pain. Unlike aspirin, ibuprofen offers better pain relief with a more favorable dosing profile, making it a suitable alternative for dysmenorrhea management in most patients.

Choice C reason: Acetaminophen lacks significant anti-inflammatory effects, as it primarily inhibits COX enzymes in the central nervous system, not peripherally. It reduces pain and fever but does not effectively target prostaglandin-mediated inflammation in menstrual cramps. Therefore, it is less effective than NSAIDs like ibuprofen for dysmenorrhea, making it an inappropriate substitute in this context.

Choice D reason: Avoiding COX inhibitors due to Reye’s syndrome risk is unwarranted here, as Reye’s syndrome is primarily associated with aspirin use in children with viral infections. Menstrual cramps are unrelated to this condition, and COX inhibitors like NSAIDs are standard treatment. This choice is overly restrictive and not clinically justified for managing dysmenorrhea.