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EDAPT:144 Anti-Inflammatory
Questions With Correct Answers
Colchicine is best taken __________ to aid absorption but is best tolerated __________. - โ โ Without food With food Nonsteroidal anti-inflammatory drugs (NSAIDs) used to treat gout can affect multiple systems within the body. Which systems can it affect? Select all that apply. - โ โ Hematologic Renal Cardiovascular Gastrointestinal Which outcome statements for gout treatment are correct? Select that all apply. - โ โ The client should know what adverse effects and symptoms to report.
The client should be able to verbalize or demonstrate knowledge of the disease process, needed lifestyle change, and required drug therapy.
The client should remain at or near pain-free during periods of inflammation with the disease process.
The client should also remain free from injury. A client has been prescribed allopurinol. Which statement made by the client requires follow-up by the nurse? - โ โ "This medication will help relieve the inflammation and pain during an acute attack." The nurse is performing a head-to-toe assessment on a client with a history of gout. At which site does gout most often start? - โ โ Big toe Which client is at highest risk for developing gout? - โ โ A 45-year- old male with a body mass index (BMI) of 40 who reports taking hydrochlorothiazide and acetylsalicylic acid. During a home healthcare visit, the nurse is helping a client identify foods that can aggravate gout. Which foods should be avoided? Select all that apply. - โ โ Sweetbreads Craft beer Sardines Which items are risk factors for developing gout? Select all that apply. - โ โ Obesity Eating foods high in purines Drinking alcohol Eating foods high in fructose Male gender Which medical conditions increase the risk of developing gout? Select all that apply. - โ โ Insulin resistance
Use corticosteroids cautiously when treating clients with gastritis, reflux disease, or ulcer disease, because these drugs can potentially cause gastric __________.
Use corticosteroids cautiously in clients with cardiac, renal, and/or liver dysfunction, because these drugs can potentially cause __________. - โ โ Increase Immunosuppressant Perforation Fluid retention and alterations in elimination The nurse is providing education to a client who has been prescribed prednisone. Which statement by the client indicates a need for further teaching? - โ โ "I can stop taking prednisone as soon as I feel better." The nurse is caring for a client who has just been diagnosed with Addison's disease. The nurse understands that the mineralocorticoid __________ and a glucocorticoid __________ will likely be prescribed. - โ โ Fludrocortisone Prednisone Unlike other glucocorticoids, prednisone has minimal impact on __________. - โ โ Adrenal insufficiencies
Prednisone is a(n) __________ acting systemic glucocorticoid with a half-life of 18-36 hours. - โ โ Intermediate When teaching a client about cortisol, the nurse should include information on which factors that increase cortisol levels? Select all that apply. - โ โ Physiologic stress Emotional stress Surgery Trauma When exogenous glucocorticoids are administered, the body stops producing exogenous hormones. Therefore, if the exogenous hormones are stopped abruptly, adrenal __________ will result. - โ โ Suppression The client taking a newly ordered glucocorticoid medication asks the nurse why it must be taken at a specific time each day. The nurse explains that this type of medication is best taken __________ since this is the time when the body produces the greatest amount of these hormones. - โ โ Early in the morning While teaching a client about a newly prescribed steroidal anti- inflammatory medication, the nurse should include which reasons to not stop taking the medication abruptly? Select all that apply. - โ โ While taking the medication, the body produces fewer glucocorticoids.
Gastrointestinal (GI) upset may occur.
The clinic nurse is reviewing the health records of four clients who walked into the clinic after starting steroidal anti-inflammatory medications. Which client should the nurse assess first? - โ โ An older adult with diabetes mellitus type 2 and cardiovascular disease whose adult child noticed confusion. What information should the nurse include when teaching a client with asthma being discharged with a prescription for prednisone? Select that all apply. - โ โ The medicine may interfere with sleep, so take the dose at the same time each morning. The nurse is reviewing the health record of a client receiving prednisone for adrenal insufficiency and furosemide for edema. Which documented findings should the nurse report to the healthcare provider immediately? Select that all apply. - โ โ Weight increased 2.3 lb (1.04 kg) in one day Serum potassium 2.7 mEq/L (reference: 3.5-5.0 mEq/L) Dark, tarry stools The nurse documents that client teaching has been effective when a client being discharged with a prescription for prednisolone includes which reasons for contacting their healthcare provider during the teach-back session? Select all that apply. - โ โ Fever Dyspnea Non-healing sores Mood swings Severe abdominal pain
Which statements are true about prednisone? Select all that apply. - โ โ A corticosteroid, similar to the type of hormone also produced by the adrenal cortex (outer layer of the adrenal gland)
A glucocorticoid (a type of corticosteroid) with mainly anti- inflammatory and immunosuppressant effects
Has minimal fluid and electrolyte balance effects (mineralocorticoid activity)
Is administered orally
Has systemic effects For which client should the nurse withhold a new order for prednisone, 60 mg by mouth once daily, and contact the prescribing healthcare provider? - โ โ An older adult with osteoporosis and a fractured hip. The nurse working in the trauma intensive care unit (ICU) is reviewing the admission orders of an older adult admitted with a left leg immobilizer and wounds to the torso, arms, legs, and feet after a motorcycle crash. Nurses in the emergency department reported that the wounds were flushed with sterile saline prior to the dressings being applied. The client's home medications include long-term use of dexamethasone tablets for an autoimmune disorder and topical cream
For each effect of nonsteroidal anti-inflammatory drugs (NSAIDs) within the body, indicate if the response results from blocking the COX- and/or COX-2 enzyme. Each effect may be caused by both enzymes. - โ โ COX-1: Antipyretic Anti-inflammatory Protects gastric mucosa Analgesic Antiplatelet
COX-2: Antipyretic Anti-inflammatory Analgesic Antiplatelet Acetylsalicylic acid directly affects cyclooxygenase- (COX-) _____ decreasing the formation of __________ leading to a decrease in __________ aggregation. - โ โ 1 Thromboxane A Platelet
Within the nonsteroidal anti-inflammatory drugs (NSAIDs) class of medications, the only COX-2 specific inhibitor is __________. - โ โ Celecoxib Nonsteroidal anti-inflammatory drugs (NSAIDs) should be avoided with which medications? Select all that apply. - โ โ Antiplatelet agents Warfarin Nonsteroidal anti-inflammatory drug (NSAID) side effects (e.g., protecting gastric mucosa, decreasing platelet aggregation, and vasoconstriction) are due to the inactivation of cyclooxygenase-1 and 2 resulting in the loss of the protective properties of __________. - โ โ Prostaglandins For each client symptom or health alteration, indicate if it is an indication for use and/or a side effect of nonsteroidal anti- inflammatory drug (NSAID) therapy. Note: Items may be both an indication for use and a side effect. - โ โ Indication for Use of NSAID: Osteoarthritis Headache Postoperative pain Muscle pain
Side Effect of NSAID: Indigestion
Increased Gastrointestinal Side Effects: Salicylates
Decreased Medication Effectiveness: Salicylates Diuretics Antihypertensives What is the primary indication for administering low-dose acetylsalicylic acid daily? - โ โ Cardiovascular protection Which three properties do all nonsteroidal anti-inflammatory drugs (NSAIDs) share? Select that all apply. - โ โ Analgesic Anti-inflammatory Antipyretic __________ is commonly used to prevent myocardial infarctions and transient ischemic attacks. - โ โ Aspirin To which class of medications do salicylates belong? - โ โ Nonsteroidal anti-inflammatory (NSAIDs) Salicylates are used as which of the following? Select all that apply. - โ โ Antiplatelet Anti-inflammatory Analgesic
Antipyretic Aspirin is a(n) __________ inhibitor of cyclooxygenase 1 (COX-1) receptors within the platelets themselves. It causes a(n) __________ in the formation of thromboxane A2, a substance that normally __________ platelet aggregation. - โ โ Irreversible Reduction Promotes Aspirin is commonly used to prevent which conditions? Select all that apply. - โ โ Myocardial infarction (MI) Cerebral vascular accident (CVA or stroke) Transient ischemic attacks (TIA) By which routes can salicylates be administered? Select all that apply. - โ โ Rectal Oral Clients with which conditions should use aspirin with caution? - โ โ Bleeding disorders Reye's syndrome is a(n) __________ and potentially life-threatening condition that can cause progressive and possibly permanent __________ damage. - โ โ Acute Neurologic Which clinical manifestations are adverse effects of salicylates? Select all that apply. - โ โ Gastrointestinal (GI) bleeding
Irreversible inhibitor of cyclooxygenase 1 (COX-1) receptors within platelets.
Inhibits prostaglandin production Place the correct response in each blank cell to complete the table. - โ โ Route: PO Onset: 5-30 minutes Peak: 1-3 hours Duration: 3-6 hours In which class of medications do propionic acid derivatives belong? - โ โ Nonsteroidal anti-inflammatory (NSAIDs) The __________ of ibuprofen include analgesia, anti-inflammatory, and antipyretic. - โ โ Therapeutic effects Select whether each item is either an indication for use or a contraindication for ibuprofen by dragging it to the correct column. - โ โ Indications: Antipyretic action Osteoarthritis Musculoskeletal disorders Dysmenorrhea
Contraindications: Severe heart failure Congenital heart disease Phenylketonuria What are the therapeutic effects of ibuprofen? Select all that apply. - โ โ Antipyretic Analgesia Anti-inflammatory What are the available routes of administration for ibuprofen? Select all that apply. - โ โ Intravenous Oral Ibuprofen works by __________ prostaglandin synthesis, thereby reducing pain, inflammation, and fever. - โ โ Inhibiting Taking ibuprofen with aspirin, oral potassium, other nonsteroidal anti- inflammatory drugs (NSAIDs), corticosteroids, or alcohol will __________ gastrointestinal (GI) effects. - โ โ Increase When taken orally, the __________ absorbs __________ of ibuprofen, as compared to __________ absorption when administered intravenously (IV). Once in the body, ibuprofen is metabolized by the __________ and excreted through the __________. - โ โ Gastrointestinal (GI) tract
nurse determines that which two side effects do not require emergency intervention? Select that all apply. - โ โ Slow mental processing Loose, watery stools A client taking ibuprofen for osteoarthritis mentions having four (4) alcoholic drinks per day. Based on this information, the nurse should teach the client about which risk of drinking alcohol while taking ibuprofen? - โ โ Increased risk of gastrointestinal (GI) bleeding Which clients should not receive ibuprofen? Select all that apply. - โ โ A middle-aged adult who smokes and has bleeding gastric ulcers A teen living with phenylketonuria A 2-month-old with a temperature of 102.9 ยฐF (39.4 ยฐC) What is the main action of ibuprofen? - โ โ Inhibiting prostaglandin synthesis Complete the chart with the onset, peak, and duration for ibuprofen PO and IV routes. - โ โ Route: PO Onset: 0.5-2.5 hours Peak: 1-4 hours Duration: 4-8 hours
Route: IV Onset: 0-2 hours Peak: 10-12 hours
Duration: 4-6 hours A client at high risk for an embolic stroke tells the nurse that they are starting a new medication to decrease blood clotting but cannot recall the name. When asked to name the drug, which answer provided by the nurse is best? - โ โ Acetylsalicylic acid The nurse confirms that a client taking a nonsteroidal anti- inflammatory drug (NSAID) for the first time understands its therapeutic uses when they mention which actions of the medication? Select all that apply. - โ โ Anti-inflammatory Analgesic Antipyretic The nurse should contact the prescribing healthcare provider before administering naproxen to a client who is already taking which medication? - โ โ Warfarin A client is prescribed celecoxib. Review the client's health record and select the documented findings that should prevent the client from receiving this medication.
Melissa (pronouns: she/her/hers) is a 78-year-old female admitted with pneumonia. She has a history of chronic obstructive pulmonary disease (COPD) and has been a smoker for 25 years. She has allergies to sulfa, codeine, and pollen. - โ โ Sulfa Sixty minutes after administering naproxen 250 mg po to a client experiencing pain and limited function in their left knee related to
