A client has been advised to take a low-dose aspirin daily for prophylaxis of adverse cardiac events. The client states, "I can't take aspirin because it upsets my stomach. Can I take ibuprofen instead?" How should the nurse respond?
1. "Ibuprofen works differently than aspirin."
2. "Ibuprofen is not safe when used with your anticoagulant therapy."
3. "Ibuprofen has no effect on blood coagulation."
4. "Taking ibuprofen will significantly increase your risk of respiratory failure."
Correct Answer: 1
Rationale 1: Because ibuprofen has less effect on coagulation, it is not used for the prophylaxis of adverse cardiac events.
Rationale 2: Although nonaspirin NSAIDs affect blood coagulation, the action is short-lived, and they are relatively safe to use with anticoagulants.
Rationale 3: Although nonaspirin NSAIDs affect blood coagulation, the action is short-lived.
Rationale 4: In general, nonaspirin NSAIDs do not increase the risk of respiratory failure.
Global Rationale: There are important differences between aspirin and the ibuprofen-like agents in their effects on the blood and heart. Although ibuprofen-like drugs affect blood coagulation, their action is short lived and they are relatively safe to use with anticoagulants. Because they have less antiplatelet effect, the ibuprofen-like agents are not used for the prophylaxis of adverse cardiovascular events. In fact, some of the nonaspirin NSAIDs such as indomethacin and sulindac significantly increase the risk of cardiovascular events. Caution should be used with all the nonaspirin NSAIDs when they are given for prolonged periods to patients with a history of cardiac disease, but do not increase risk of respiratory failure
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