A patient who has arthritis has been taking ibuprofen [Motrin] and a glucocorticoid medication. The patient reports having tarry stools but denies gastric pain. Which action by the nurse is cor-rect?
a. Contact the provider to discuss ordering an antiulcer medication.
b. Counsel the patient to use over-the-counter antacids.
c. Reassure the patient not to worry unless there is gastric pain.
d. Tell the patient to stop taking the gluco-corticoid immediately.
A
Glucocorticoid therapy, especially when combined with NSAIDs, can increase the risk of gastric ulcer and possibly GI bleeding. Treatment with antiulcer medications is indicated, but not with OTC antacids, since the provider needs to be aware of this adverse effect. Gastric pain is usually decreased because of the glucocorticoids, so absence of gastric pain is not reassuring. The glu-cocorticoid should be withdrawn slowly, not immediately.
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