Author Question: A client has been admitted to the medicalsurgical unit for pain evaluation. The client has arthritis ... (Read 49 times)

WhattoUnderstand · **on:** Jul 23, 2018

A client has been admitted to the medicalsurgical unit for pain evaluation. The client has arthritis and has been taking ibuprofen for many years to help alleviate the pain. What is the most important assessment for this client?

1. Respiratory auscultation to rule out congestion
2. Reviewing renal laboratory studies
3. A complete blood count (CBC) with differential to monitor for infection
4. An electrocardiogram for possible cardiomyopathy

Question 2

A client has been prescribed acetaminophen and has been instructed by the nurse not to take any over-the-counter (OTC) cough or cold medications without first checking with the health care provider or pharmacist.

What is the rationale for this instruction?
1. There could be an increased risk for bleeding in the stomach and within other organs of the body.
2. Cough medications and other OTC drugs could contain acetaminophen, so inadvertent overdose could occur.
3. There is an increased risk for Reye's syndrome.
4. No one should be taking more than one medication for pain.

Juro · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 2
Rationale 1: Respiratory congestion is not the primary concern for this client.
Rationale 2: When used for a long duration, ibuprofen can cause renal insufficiency.
Rationale 3: Infection is not the primary concern for this client.
Rationale 4: Cardiomyopathy is not the primary concern for this client.
Global Rationale: Chronic use of ibuprofen may lead to renal impairment, including acute renal failure, polyuria, azotemia, cystitis, hematuria, and increased creatinine and blood urea nitrogen levels. Respiratory congestion, infection, and cardiomyopathy is not a primary concern for this patient.

Answer to Question 2

Correct Answer: 2
Rationale 1: Acetaminophen is not implicated in bleeding.
Rationale 2: Many over-the-counter medications contain acetaminophen that could cause the client to inadvertently overdose.
Rationale 3: Reye's syndrome occurs when children under the age of 18 are administered aspirin or other salicylates due to flu-like symptoms.
Rationale 4: Many clients require multiple medications for pain; however, they should be closely monitored by their health care provider.
Global Rationale: Acetaminophen is a primary alternative to NSAIDs when patients have a contraindication to taking aspirin or ibuprofen. It is frequently combined with other OTC cold and flu preparations and with opioid analgesics. Patients taking acetaminophen routinely should be careful to avoid overdose. Acetaminophen is not implicate in bleeding and does not increase risk for Reye's syndrome. More than one medication for pain may be necessary.