The nurse is administering ibuprofen (Advil) to an older patient. Which assessment data causes the nurse to hold the medication?
Patient reports pain on 4/10 scale in right shoulder
Patient experiences respiratory depression after administration of an opioid medication.
Patient reports last bowel movement was 2 days ago.
Patient reports past medical history of gastric ulcer.
The Correct Answer is D
Choice A reason: Pain of 4/10 indicates a need for analgesia, and ibuprofen is appropriate for mild to moderate pain. This does not warrant holding the medication, as it aligns with the drug’s therapeutic purpose.
Choice B reason: Respiratory depression from opioids is unrelated to ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID). While concerning, it does not contraindicate ibuprofen administration, though it requires separate intervention for opioid toxicity.
Choice C reason: A bowel movement 2 days ago suggests mild constipation, not a contraindication for ibuprofen. While NSAIDs can cause gastrointestinal irritation, this finding alone does not justify holding the medication without further symptoms.
Choice D reason: A history of gastric ulcer is a contraindication for ibuprofen, an NSAID that inhibits prostaglandins, reducing gastric mucosal protection. This increases the risk of ulcer reactivation or bleeding, necessitating withholding the medication.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Green liquid stool in a colostomy pouch is often benign, resulting from diet (e.g., green vegetables) or medications. In an 80-year-old, this is not immediately concerning unless accompanied by systemic symptoms like fever or pain.
Choice B reason: Slight bleeding when wiping a colostomy is common, especially in an 18-year-old with a new stoma, due to fragile tissue. It warrants monitoring but is not as concerning as signs of poor stoma viability.
Choice C reason: A red, moist colostomy in a 45-year-old indicates a healthy, well-perfused stoma, which is normal post-placement. This is an expected finding and does not raise immediate concern compared to abnormal stoma appearance.
Choice D reason: A pale pink/purple colostomy suggests poor perfusion or ischemia, especially in a 55-year-old. This abnormal color, even with moisture, indicates potential stoma necrosis, requiring urgent assessment to prevent complications like tissue death or infection.
Correct Answer is B
Explanation
Choice A reason: Offering the bedpan every 2 hours does not directly stimulate peristalsis. While regular toileting may prevent constipation, it lacks the mechanical or physiological stimulus needed to enhance bowel motility, especially in postoperative patients at risk for paralytic ileus.
Choice B reason: Ambulation promotes peristalsis by stimulating abdominal muscles and increasing intra-abdominal pressure, which encourages bowel motility. Early mobilization post-surgery enhances blood flow to the gastrointestinal tract, reducing the risk of paralytic ileus by counteracting slowed motility from anesthesia or immobility.
Choice C reason: Increasing protein intake supports tissue repair but does not directly stimulate peristalsis. Protein metabolism may increase stool bulk over time, but it lacks the immediate mechanical or neural stimulation needed to prevent or treat paralytic ileus in the postoperative period.
Choice D reason: Decreasing fluid intake can worsen bowel motility by reducing stool hydration, leading to harder stools and increased risk of constipation. Adequate hydration is essential for maintaining soft stool and supporting peristalsis, making this intervention counterproductive.
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