A patient is taking ibuprofen 400 mg every 4 hours to treat ...

[washai]

A patient is taking ibuprofen 400 mg every 4 hours to treat moderate arthritis pain and reports that it is less effective than before. What action will the nurse take?
 
  a. Counsel the patient to discuss a prescription NSAID with the provider.
  b. Recommend adding aspirin to increase the antiinflammatory effect.
  c. Suggest asking the provider about a short course of corticosteroids.
  d. Tell the patient to increase the dose to 800 mg every 4 hours.

Question 2

A patient is taking aspirin to help prevent myocardial infarction and is experiencing moderate gastrointestinal upset. The nurse will contact the patient's provider to discuss changing from aspirin to which drug?
 
  a. A COX-2 inhibitor
  b. Celecoxib (Celebrex)
  c. Enteric-coated aspirin
  d. Nabumetone (Relafen)

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Answer to Question 1

ANS: A
The patient should discuss another NSAID with the provider if tolerance has developed to the over-the-counter NSAID. Patients should not take aspirin with NSAIDs because of the increased risk of bleeding and gastrointestinal upset. Steroids are not the drugs of choice for arthritis because of their side effects and are not used unless inflammation is severe. A prescription NSAID would be used prior to starting corticosteroids. Increasing the dose will increase side effects but may not increase desired effects. The maximum dose per day is 2400 mg, which would most likely be exceeded when increasing the dose to 800 mg every 4 hours.

Answer to Question 2

ANS: C
Aspirin is used to inhibit platelet aggregation to prevent cardiovascular accident and myocardial infarction. Patients taking aspirin for this purpose would not benefit from COX-2 inhibitors, since the COX-1 enzyme is responsible for inhibiting platelet aggregation. The patient should take enteric-coated aspirin to lessen the gastrointestinal distress. Celecoxib and nabumetone are both COX-2 inhibitors.

[washai]

TYSM

[bimper21]

Excellent