Chapter 13: Nonopioid Analgesics: Salicylates and Nonsalic- ylates Introductory Clinical Pharmacology 12th Edition by Susan M Ford

Introductory Clinical Pharmacology 12th Edition by Susan M Ford 1. A 6-year-old client is presenting with signs and symptoms of fever, cough, stuffy nose, general malaise, and muscle aches. The nurse prepares to administer which medication to this client? a. Aspirin b. Magnesium salicylate c. Acetaminophen d. Diflunisal Answer: C Rationale: The known actions of acetaminophen include treating mild to moderate pain and reducing fever. Children and teenagers with influenza or chickenpox should not take salicylates, particularly aspirin, because of the association of developing Reye syndrome. Magnesium salicylate and diflunisal are also salicylates. Question Format: Multiple Choice Chapter: 13 Learning Objective: 5 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 166, Contraindications 2. A client receiving warfarin for atrial fibrillation is requesting pain medication for a headache and for home use. Which medication does the nurse anticipate the health care provider will suggest? a. Bufferin b. Tylenol c. Ecotrin d. Empirin Answer: B Rationale: Clients taking warfarin should avoid the use of salicylates (Bufferin, Ecotrin, and Empirin) and should be encouraged to use the nonsalicylate Tylenol (acetaminophen). Question Format: Multiple Choice Chapter: 13 Learning Objective: 5 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Teaching/Learning Reference: p. 166, Contraindications 3. A client is asking the nurse about changing from aspirin to using willow bark. Which advantage of willow bark would the nurse integrate into the answer? a. Willow bark is ideal for clients with peptic ulcers. b. Willow bark works relatively quickly as compared to aspirin. c. Small amounts of willow bark produce a noticeable effect. d. Willow bark has fewer adverse reactions than other salicylates. Answer: D Rationale: Willow bark causes fewer adverse reactions than other salicylates. The nurse should inform the client and family members that willow bark treatment should be given cautiously to clients with peptic ulcers. Willow bark takes more time to take effect, and it has to be given in large amounts to produce a significant effect. Question Format: Multiple Choice Chapter: 13 Learning Objective: 5 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Teaching/Learning Reference: p. 165, Herbal Considerations 4. A nurse is assessing a client after administering aspirin for pain. Which finding should the nurse prioritize? a. Constipation b. Bradycardia c. Sleeplessness d. Flushing Answer: D Rationale: Flushing is one of the symptoms of salicylism that the nurse should monitor for. Tachycardia, not bradycardia, is a symptom of salicylism. Sleeplessness and constipation are not symptoms of salicylism. Question Format: Multiple Choice Chapter: 13 Learning Objective: 3 Cognitive Level: Apply Client Needs: Physiological Integrity: Reduction of Risk Potential Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 166, Chronic Care Considerations 5. A 15-year-old client is brought to the emergency department after the parents discovered the client has taken 15 gm of acetaminophen over the past 24 hours for back pain. Which assessment finding should the nurse prioritize? a. Hypotension b. High fever c. Sweating d. Rapid, deep breathing Answer: A Rationale: Hypotension is one of the signs of acute acetaminophen toxicity that the nurse should monitor for in the client. High fever, sweating, and rapid, deep breathing are not symptoms generally associated with acute acetaminophen toxicity. Question Format: Multiple Choice Chapter: 13 Learning Objective: 2 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 166, Nonsalicylates 6. A client with diabetes is taking acetaminophen for pain. When assessing the client which factor should the nurse closely monitor? a. Arterial blood pH b. Blood pressure c. Blood glucose levels d. Blood creatinine levels Answer: C Rationale: When administering acetaminophen to clients with diabetes, care needs to be taken when blood glucose testing is done because acetaminophen may alter blood glucose test results, causing falsely lower blood glucose values. Acetaminophen does not significantly alter pH level, blood pressure, or blood creatinine levels in a client with diabetes. Question Format: Multiple Choice Chapter: 13 Learning Objective: 3 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 167, Contraindications and Precautions 7. The nurse is developing a plan of care for a client ordered to take acetaminophen for pain relief. The nurse will monitor the client for liver failure if there is a history of which disorder?