The practical nurse (PN) is caring for a client who has been taking ibuprofen for arthritic pain. Which action should the PN include in the client’s plan of care (POC)?
Observe for signs of gastrointestinal (GI) bleeding
Monitor the blood pressure frequently
Give the medication on an empty stomach
Encourage sunblock when outside
The Correct Answer is A
Choice A reason: Ibuprofen, a nonsteroidal anti-inflammatory drug, inhibits prostaglandins, reducing gastric mucosal protection and increasing GI bleeding risk. Symptoms like melena or hematemesis may occur, especially with prolonged use. Monitoring for bleeding is critical to detect early complications, ensuring timely intervention to prevent severe outcomes.
Choice B reason: While ibuprofen can elevate blood pressure by affecting renal prostaglandins and sodium retention, this is less immediate than GI bleeding risk. Frequent blood pressure monitoring is relevant for long-term use but not the primary concern compared to the acute danger of GI hemorrhage.
Choice C reason: Giving ibuprofen on an empty stomach increases GI irritation, as food buffers gastric acid, reducing ulcer risk. This choice is incorrect, as it contradicts best practice, which recommends taking ibuprofen with food to minimize mucosal damage and bleeding risk.
Choice D reason: Sunblock is irrelevant to ibuprofen’s effects, as it does not cause photosensitivity. This action applies to drugs like tetracyclines, not NSAIDs. Monitoring for GI bleeding is far more critical, as ibuprofen’s primary adverse effect involves the gastrointestinal tract, not skin.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Appetite changes may occur with levothyroxine due to metabolic effects, but they are not the most critical side effect. Excessive thyroid hormone can overstimulate metabolism, but cardiovascular effects, like tachycardia, are more immediate and dangerous, making appetite monitoring less urgent.
Choice B reason: Sleep disturbances may result from levothyroxine’s stimulatory effects, but they are less severe than cardiovascular risks. Overdose can cause insomnia by increasing metabolism, but heart rate is a more direct indicator of hyperthyroidism, which poses greater health risks, making this choice secondary.
Choice C reason: Heart rate is critical to monitor, as levothyroxine increases metabolism, potentially causing tachycardia or arrhythmias if overdosed. Excess thyroid hormone mimics hyperthyroidism, stressing the cardiovascular system, which can lead to palpitations or heart failure, making this the most important parameter for side effect detection.
Choice D reason: Daily weights track fluid or metabolic changes but are less specific for levothyroxine side effects. Weight loss may occur with excess dosing, but cardiovascular effects, like increased heart rate, are more immediate and life-threatening, requiring closer monitoring than weight fluctuations.
Correct Answer is A
Explanation
Choice A reason: Polyethylene glycol, a bowel prep for colonoscopy, requires rapid drinking at specified intervals to ensure effective colon cleansing. This osmotic laxative draws water into the bowel, promoting evacuation. Consistent, rapid intake ensures complete bowel clearance, critical for clear visualization during the procedure.
Choice B reason: Diluting polyethylene glycol with fruit juice is incorrect, as it may alter the solution’s osmotic balance, reducing efficacy. The preparation must remain undiluted to draw sufficient water into the colon for cleansing, making this instruction inappropriate for achieving a clear colonoscopy.
Choice C reason: Drinking polyethylene glycol with a meal is incorrect, as food can interfere with bowel cleansing. The solution is taken on an empty stomach, typically the day before the exam, to ensure the colon is clear, making this instruction counterproductive to the prep’s purpose.
Choice D reason: Watery diarrhea is the expected outcome of polyethylene glycol, not an adverse effect requiring reporting. It indicates effective bowel cleansing for colonoscopy. Instructing to report this normal response is unnecessary and may cause confusion, as diarrhea is the goal of the preparation.
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