A nurse is teaching a nursing student who wants to know how ...

[genevieve1028]

A nurse is teaching a nursing student who wants to know how aspirin and nonaspirin first-generation NSAIDs differ. Which statement by the student indicates a need for further teaching?
 
  a. Unlike aspirin, first-generation NSAIDs cause reversible inhibition of cyclooxygenase.
  b. NSAIDs do not increase the risk of MI and stroke; however, unlike ASA, they do not provide protective benefits against those conditions.
  c. Unlike aspirin, first-generation NSAIDs do not carry a risk of hypersensitivity reactions.
  d. Unlike aspirin, first-generation NSAIDs cause little or no suppression of platelet aggregation.

Question 2

A nurse is caring for a patient who has been taking low-dose aspirin for several days. The nurse notes that the patient has copious amounts of watery nasal secretions and an urticarial rash. The nurse will contact the provider to discuss:
 
  a. administering epinephrine.
  b. changing to a first-generation NSAID.
  c. reducing the dose of aspirin.
  d. giving an antihistamine.

[hanadaa]

Answer to Question 1

ANS: C
Nonaspirin first-generation NSAIDs carry a risk of hypersensitivity reactions similar to the risk posed by ASA. These agents cause reversible COX inhibition, whereas ASA causes irreversible COX inhibition. NSAIDs do not provide protective benefits for MI or stroke, as does ASA. Nonaspirin first-generation NSAIDs do cause suppression of platelet aggregation, but the suppression is reversible.

Answer to Question 2

ANS: A
Aspirin can cause a hypersensitivity reaction in some patients. This may start with profuse, water rhinorrhea and progress to generalized urticaria, bronchospasm, laryngeal edema, and shock. It is not a true anaphylactic reaction, because it is not mediated by the immune system. Epinephrine is the treatment of choice. Patients with sensitivity to ASA often also have sensitivity to NSAIDs; the first indication with this patient is to treat the potential life-threatening effect, not to change the medication. Reduction of the dose of ASA is not indicated, because this reaction is not dose dependant. Antihistamines are not effective, because this is not an allergic reaction.