A client who was taking large doses of ibuprofen (Motrin) for over a year developed a peptic ulcer. The client asks the nurse why this occurred. The nurse best answers the client by stating:

Question

1. "Motrin works against your own body's ulcer defenses."
2. "It sounds like your stress might have caused your ulcer."
3. "Taking Motrin cannot cause a peptic ulcer."
4. "The natural defenses of your large intestine were overwhelmed."

Answer 1

Correct Answer: 1
Rationale 1: Ibuprofen is a prostaglandin antagonist. This will decrease the defenses of the gastric mucosa and could precipitate a peptic ulcer.
Rationale 2: The nurse does not answer the client's question correctly and is eliciting information that is not pertinent to the discussion at this time.
Rationale 3: The use of NSAIDs and corticosteroids is associated with the development of peptic ulcers.
Rationale 4: Ibuprofen is a prostaglandin antagonist. This will decrease the defenses of the gastric mucosa and could precipitate a peptic ulcer.
Global Rationale: Several frequently prescribed drugs, including corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDs), cause peptic ulcers because they are prostaglandin antagonists. These drugs suppress the secretion of mucus and bicarbonate, the repair of damaged gastric mucosal cells, and the increase of blood flow to the mucosa. It is unknown if stress is implicated in this patient's condition, but it is known that use of NSAIDs increases risk for peptic ulcer.