A client has been diagnosed with early osteoarthritis (OA) in the hips. The nurse explains that the first medical treatment that will be tried is administration of
a. acetaminophen (Tylenol).
b. celecoxib (Celebrex).
c. misoprostol (Citotec).
d. nonsteroidal anti-inflammatory drugs (NSAIDs).
A
NSAIDs used to be the mainstay of treatment, but because OA has minimal inflammatory properties and because of the safety concerns with long-term use of NSAIDs, acetaminophen is now considered the first-line choice. The client can be switched to an NSAID when pain is severe despite the maximum dose of acetaminophen. Celecoxib is a COX-2 selective NSAID that has fewer GI side effects than other NSAIDs but has serious safety concerns as well. Misoprostol is a synthetic prostaglandin that clients may take to minimize GI side effects of medications.
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The nurse is working on the orthopedic unit, and is caring for a client who complains of back pain. Which responses by the nurse would be appropriate when caring for this client?
Select all that apply. 1. "I'm sorry you're hurting. I want to make you feel better." 2. "People with back pain experience very different symptoms. Tell me more about your back." 3. "You had medication for your pain at 4 p.m., so I can't give you any more until 8 p.m., because the health care provider ordered it every 4 hours." 4. "Does anything other than your back hurt?" 5. "Why don't you try another position to make it feel better until it's time for more pain medication?"
A child is diagnosed with stage IV neuroblastoma and has undergone abdominal surgery to remove the tumor. He is now receiving chemotherapy. Which nursing diagnosis would be most important?
A) Risk for infection related to chemotherapy B) Impaired skin integrity related to abdominal surgery C) Grieving related to advanced disease and poor prognosis D) Imbalanced nutrition related to adverse effects of chemotherapy
An older adult female has a bone density test that reveals severe osteoporosis. What does the nurse understand can be a problem for this client due to the decrease in bone mass and density?
A) Diabetes B) Hypertension C) Compression fractures D) Cardiac disease
Which type of management would be most appropriate for a nurse to use when helping clients improve their health status?
a. Utilization management b. Case management c. Disease management d. Demand management