Which laboratory value should the practical nurse (PN) monitor to determine if an antilipidemic medication is having the desired effect for the client?

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.

Choice A reason: Rivaroxaban, a direct oral anticoagulant, inhibits factor Xa, increasing bleeding risk. Bruising on arms and legs may indicate excessive anticoagulation, potentially leading to severe hemorrhage. Immediate reporting is critical to assess bleeding risk, adjust dosing, or initiate interventions to prevent life-threatening complications.

Choice B reason: Genital itching and burning with discharge suggest a possible infection or allergic reaction, not a direct adverse effect of rivaroxaban. These symptoms are unrelated to its anticoagulant mechanism, which primarily affects hemostasis, making this choice incorrect for immediate reporting.

Choice C reason: Diminished taste and smell are not recognized side effects of rivaroxaban. These symptoms may relate to other conditions, like neurological or infectious issues, but do not reflect the drug’s anticoagulant effects. This choice is irrelevant to rivaroxaban’s adverse effect profile.

Choice D reason: Hard, dry stools indicate constipation, a non-urgent side effect not typically associated with rivaroxaban. While gastrointestinal issues may occur, bleeding risks are more critical. This symptom does not warrant immediate reporting compared to bruising, which signals potential hemorrhage.