Exhibits

The nurse is reviewing provider orders for Mrs. Thompson who is in the end- of-life stage. Match each provider order with its appropriate category: anticipated, nonessential, or contraindicated. Select the correct category for each given order.

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.

A. Designing and delivering educational sessions on healthy lifestyle choices and preventive measures to the community. This is the best reflection of the nurse’s role in community health promotion. Educating the community about risk factors, lifestyle modifications, and disease prevention empowers individuals to take proactive steps toward reducing the incidence of chronic diseases.
B. Conducting individual health screenings and providing personalized counseling for each participant. While health screenings and personalized counseling are important, they focus more on individual care rather than broad community health promotion. A community health nurse’s primary role is to implement population-level strategies that benefit the entire community.
C. Providing one-on-one medical treatment for community members who are currently experiencing chronic disease symptoms. Treating individuals with chronic disease symptoms is essential but does not reflect the broader public health role of a community nurse. Prevention and health promotion efforts have a greater long-term impact on reducing chronic disease rates.
D. Focusing solely on treating acute health issues as they arise within the community. Addressing acute health issues is necessary, but focusing solely on treatment rather than prevention does not align with the primary goal of community health nursing, which is to promote wellness and prevent disease at the population level.